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Application of Lean Principles to Improve Operational Efficiency in Health Check-up Department


  • Karan P. Mansukhani
  • Agency : Health Check-Up Department, Operational Efficiency, Lean Principles, SWOT Analysis
  • Objective : To map the health checkup customer, staff and information flow. To conduct SWOT analysis of the health check up department. To compare health checkup cycle time, Interval time, waiting time and turn around time for each package. To isolate the critical defects/delays of each health checkup package. To identify the medical reports those have a low compliance of ‘complete and accurate’ reports for health checkup executive. To identify activities where mean activity cycle time is under/over producing by comparing ‘take time’ with mean cycle time.
  • Background : A health checkup is a multi step process involving various tests/ investigations/ consultations, and is dependant on various departments for its completion. Lean principles are a set of tools which assist in diagnosing and rectifying bottlenecks. Thus, if implemented will increase operational efficiency of the department. This study was done to improve operational efficiency in the Health Checkup department, P.D. Hinduja Hospital and Medical Research Centre, Mumbai.
  • Methodology : This is an analytical study and the area of study selected were -basic, comprehensive regular, comprehensive plus, special regular, special ultra and premium. The Data collection tool used was simple format consisting of in time and out time for each step of the health checkups used to collect data for time analysis. The sample size for the study was 100. (50 males and 50 females). Selection was based on the percentage of health checkups frequencies for the period January 2009-December 2009. The sampling method is stratified random sampling SIPOC, SWOT analysis, time analysis, vital defect analysis, report delivery analysis and take time analysis was used to analyze the data.
  • Findings : The special ultra and basic packages found to have the maximum waiting time of 47 mins and the mean cycle time for basic and comprehensive regular packages are similar at 85 and 86 mins respectively (From Figure 4). However, their turn around time is 240 and 540 mins respectively. The only additions to basic are a surgeon/gynaecologist consultation and a second physician consultation 2 with reports.  Special ultra, basic, premium female have the maximum Waiting time beyond stated end time at 47, 36 and 31 minutes respectively. Premium male and comprehensive plus packages also have a waiting time beyond stated end time, but to a lesser extent at 20 and 2 minutes respectively. Comprehensive regular and comprehensive plus have the least percentage of cycle time to turn around time ratio. This means these customers are idle for a larger proportion of time, 83% and 73% respectively, with respect to the other packages, which average 64%.   The major defects in each of the packages are the consultation with doctors like the physician consultation (pre and post checkup), surgeon, gynecologist, ophthalmologist, ears-nose throat consultations. The non compliance of medical report turn around time is lowest for mammography and sonography at 40 and 74.42 percent. The mean cycle time is greater than takt time by 14,9.77,8.5,8.5,6.46 and 3.08 minutes for Ultrasound 14, Ophthalmology consultation, Ears Nose Throat consultation, pulmonary function test, Chest X-ray and ECG respectively.
  • Recommendations : There are a number of changes that can be made, using the same resources available to reduce customer turn around time and thus accommodate more health checkups. Implementing these changes, will result in a decreased customer turn around time, and enable department to accommodate a larger number of health checkups. The recommendations that are an output of this study categorized in the following categories i) Reduce turn around time, ii) System, iii) Infrastructure, iv) Poka yoke/ mistake proofing.
To map the health checkup customer, staff and information flow. To conduct SWOT analysis of the health check up department.