ArticleInternational journal of health policy and management2015
Improving wait times to care for individuals with multimorbidities and complex conditions using value stream mapping.
Article in International journal of health policy and management, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 4 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
13 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Access improvement in healthcare: a 12-step framework for operational practice.Frontiers in health services · 2024Pooled it
- Effects of Lean Interventions Supported by Digital Technologies on Healthcare Services: A Systematic Review.International journal of environmental research and public health · 2022Pooled it
- Multimorbidity and consultation time: a systematic review.BMC family practice · 2020Pooled it
- Does Value Stream Mapping affect the structure, process, and outcome quality in care facilities? A systematic review.Systematic reviews · 2017Pooled it
- Social and health determinants of wait times for primary care in Canada.Canadian family physician Medecin de famille canadien · 2025Article
- Care models for individuals with chronic multimorbidity: lessons for low- and middle-income countries.BMC health services research · 2024Article
- The Role of Value Stream Mapping in Healthcare Services: A Scoping Review.International journal of environmental research and public health · 2021Article
- Article
- Practical Use of Process Mapping to Guide Implementation of a Care Coordination Program for Rural Veterans.Journal of general internal medicine · 2019Observational
- Quality improvement of clinic flow for complex genetic conditions: Using Ehlers-Danlos syndrome as a model.Molecular genetics & genomic medicine · 2018Article
- Delivery of Community-Based Palliative Care: Findings from a Time and Motion Study.Journal of palliative medicine · 2017Article
- Meeting the needs of a complex population: a functional health- and patient-centered approach to managing multimorbidity.Journal of comorbidity · 2016Article
- Can a Healthcare "Lean Sweep" Deliver on What Matters to Patients? Comment on "Improving Wait Times to Care for Individuals with Multimorbidities and Complex Conditions Using Value Stream Mapping".International journal of health policy and management · 2015Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRecognizing the significant impact of wait times for care for individuals with complex chronic conditions, we applied a LEAN methodology, namely - an adaptation of Value Stream Mapping (VSM) to meet the needs of people with multiple chronic conditions and to improve wait times without additional resources or funding.
methodsOver an 18-month time period, staff applied a patient-centric approach that included LEAN methodology of VSM to improve wait times to care. Our framework of evaluation was grounded in the needs and perspectives of patients and individuals waiting to receive care. Patient centric views were obtained through surveys such as Patient Assessment of Chronic Illness Care (PACIC) and process engineering based questions. In addition, LEAN methodology, VSM was added to identify non-value added processes contributing to wait times.
resultsThe care team successfully reduced wait times to 2 months in 2014 with no wait times for care anticipated in 2015. Increased patient engagement and satisfaction are also outcomes of this innovative initiative. In addition, successful transformations and implementation have resulted in resource efficiencies without increase in costs. Patients have shown significant improvements in functional health following Integrated Chronic Care Service (ICCS) intervention. The methodology will be applied to other chronic disease management areas in Capital Health and the province.
conclusionWait times to care in the management of multimoribidities and other complex conditions can add a significant burden not only on the affected individuals but also on the healthcare system. In this study, a novel and modified LEAN methodology has been applied to embed the voice of the patient in care delivery processes and to reduce wait times to care in the management of complex chronic conditions.
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