Analyse de la chaine de valeur pour améliorer le flux de patients d'un service de consultations externes tunisien

INTRODUCTION: Waiting time is often viewed as the main source of dissatisfaction in public healthcare organizations in general and outpatient departments in particular. To address this issue, one alternative is to accelerate the patient flow by identifying and reducing bottlenecks. METHODS: The Value Stream Mapping (VSM) of the patient care process in a pneumology outpatient department in Tunisia allows to (i) model the process by representing its activities and the corresponding flows, (ii) identify and quantify non-value-added activities and (iii) measure the global performance by calculating the patients length of stay as well as the total percentage of added value of the process. RESULTS: The current Value Stream Mapping (VSM) identified and quantified waiting times and patient movements leading to a total added value rate below 11%. The analysis revealed three root causes: an ineffective directional signage, an inappropriate appointment scheduling and an inefficient management of medical records. CONCLUSIONS: The results of this study help managers to identify improvement opportunities that can accelerate patient flow. By including this study as part of a continuous improvement approach, it would be possible to periodically evaluate the performance of the process in order to monitor the outpatient pneumology department in a more efficient manner.