The Lean method as a clinical pathway facilitator in patients with lung cancer

Clin Respir J. 2012 Jul;6(3):169-74. doi: 10.1111/j.1752-699X.2011.00271.x. Epub 2011 Nov 15.


Introduction: Patient flow during workup for lung cancer is often difficult to influence because of delay at many levels: patient delay, doctors' delay and waiting time for X-ray and CT scan, referral to specialist, and waiting time for chemotherapy and radiotherapy or surgery. A mean workup time of 4 months is not unusual.

Objectives: To improve quality and shorten the workup time for patients with lung cancer.

Methods: It was decided to employ a program designed by the Toyota car industry, the Lean process, as a tool to improve workup time. A Lean process implicates all levels of an institution with project and focus groups having workshops to analyse present status and suggest improvements.

Results: Since introducing the Lean project, we have decreased the workup time from a mean of 64 days to 16 days, and the median time from diagnosis to surgery was reduced from 26.5 days to 15 days.

Conclusion: It is feasible to improve patient flow for patients with lung cancer by employing the Lean method as a pathway instrument.

MeSH terms

  • Adenocarcinoma / diagnosis*
  • Adenocarcinoma / surgery*
  • Adenocarcinoma of Lung
  • Carcinoma, Non-Small-Cell Lung / diagnosis
  • Carcinoma, Non-Small-Cell Lung / surgery
  • Critical Pathways / organization & administration*
  • Critical Pathways / standards
  • Feasibility Studies
  • Follow-Up Studies
  • Hospitals, University / organization & administration
  • Hospitals, University / standards
  • Humans
  • Lung Neoplasms / diagnosis*
  • Lung Neoplasms / surgery*
  • Models, Organizational
  • Outcome Assessment, Health Care*
  • Quality Assurance, Health Care / methods
  • Quality Assurance, Health Care / organization & administration
  • Time Factors