Authors (including presenting author) :
W K Pin
Affiliation :
Ambulatory Medical Centre, Kwong Wah Hospital
Introduction :
Cancer care delivery poses significant challenges due to its complex, while Hospital Authority has implemented various strategies to improve cancer care access and efficiency through its 2022-2027 strategic plan, rising service demands and complexity continue to impact wait times and service quality. At Kwong Wah Hospital, the establishment of a new integrated oncology service for day chemotherapy is part of a strategic response to fill an anticipated service gap in the Kowloon catchment area.
Objectives :
To evaluate the long-term effectiveness of lean methodology in optimizing patient flow for a chemotherapy day service over a two-year period (2022-2024).
Methodology :
Value stream mapping was utilized to visualize and track patient, material, and information flow changes. Initial improvements were implemented through DMAIC methodology with key stakeholders over two 3-month cycles. Subsequent service modifications were made to address increasing patient volume. Performance metrics included process cycle efficiency, waiting times, and service capacity. Patient and staff satisfaction were evaluated by survey and interview respectively on an ongoing basis.
Result & Outcome :
Initial process cycle efficiency improved from 1.52% to 1.94% (whole journey) and 20.7% to 37% (hospital journey). Despite a 220% increase in patient load (79 to 173 monthly attendances), clinic waiting times were maintained near baseline (47 to 43 minutes). Chemotherapy preparation time decreased from 74 to 24 minutes. Service
adaptations included restructured appointment systems, workflow modifications, and digital transformation of various processes. Treatment scheduling extended from 3-weekly to 4-5 weekly cycles due to capacity constraints.
Lean management demonstrated sustained efficiency improvements despite significant volume increases. While initial gains were achieved through process optimization, long-term sustainability required continuous adaptation to balance capacity and demand. Success factors included multidisciplinary collaboration, staff empowerment, and strategic workflow modifications aligned with a patient-centric care strategy.
