Lean Management Improves the Process Efficiency of Controlled Ovarian Stimulation Monitoring in IVF Treatment

BACKGROUND: Evaluation of patients' experiences and satisfaction is vital for assessing the quality of healthcare service, including in fertility clinics. One promising concept that has recently been widely used to increase efficiency and service quality in hospitals is the lean concept. Lean is a form of philosophy that focuses on reducing waste of a process and continuous improvement so that consumers receive greater value. This study aims to identify waste and improve efficiency using lean management methods in the controlled ovarian stimulation (COS) monitoring process during in vitro fertilization (IVF) treatment in a fertility clinic. METHODS: This study used an action research approach by observing the total service time of monitoring ovarian stimulation in IVF patients (n = 40). The identified waste and solutions were then compiled for use in a focus group discussion (FGD). From the FGD, a priority plan was obtained for the implementation of lean management. This study uses the PDCA cycle for improvement. RESULTS: Three priority solutions were chosen, which are as follows: (1) evaluating ovarian stimulation via USG only; (2) allocating more time during doctor's counselling; and (3) increasing counselling time by nurses in the injection room. The total patient wait time was reduced to 6 hours 32 minutes over the three visits, 13 hours 35 minutes decrease from before the intervention. In addition, the value-added ratio (VAR) was increased from 9% to 22% after the intervention. CONCLUSION: This research provides theoretical and practical contributions for the lean management principles in IVF treatment. The findings of this study will contribute to the pursuit of knowledge and dissemination of lean principles in the management of healthcare, including IVF clinics.