Purpose: Many healthcare organizations are looking for methods, such as Lean, to reduce their costs and increase the productivity of their professionals. The Lean method looks at every step in every process to assess if this step adds value for the customer or not. The aim of this study was to explore the value adding and non-value adding process steps in stroke patient admission in an integrated care stroke service in the Netherlands. Design/methodology/approach: This study focused on discharge of stroke patients from hospital acute treatment, and they were admitted for rehabilitation. According to the Grounded Theory, value stream mapping, organized interviews and expert meetings and coded was used. A configuration analysis was used to distinguish aggregates and configurations. Findings: The most reported issues concerned in the paper are as follows: (1) insufficient internal logistics in the hospital, (2) miscommunication about medical readiness for discharge of the patient, (3) missing or delayed medical patient information, (4) overlapping discharge interviews, (5) unsafe transfer of sensitive information and (6) waiting lists and queuing up in rehabilitation facility. Originality/value: At least six main areas of waste were identified in this stroke service, and they form the target for waste reducing activities. The results give insight in possible wastes in healthcare organizations and are therefore beneficial for other healthcare organizations which are planning to reduce wastes.

Efficiency, Integrated care, Lean, Process, Stroke
dx.doi.org/10.1108/JICA-09-2019-0042, hdl.handle.net/1765/125551
Journal of Integrated Care
Rotterdam School of Management (RSM), Erasmus University

Heijndermans, M. (Maud), Maas, A. (Alexander), Dippel, D.W.J, & Buijck, B. (Bianca). (2020). Lean: increase efficiency in stroke patient care. Journal of Integrated Care. doi:10.1108/JICA-09-2019-0042