Using Lean methodologies to streamline processing of requests for durable medical equipment and supplies for children with complex conditions

Healthc (Amst). 2018 Dec;6(4):245-252. doi: 10.1016/j.hjdsi.2017.11.003. Epub 2017 Dec 13.


Background: An improvement team from the Complex Care Center at our large pediatric medical center participated in a 60-day initiative to use Lean methodologies to standardize their processes, eliminate waste and improve the timely and reliable provision of durable medical equipment and supplies.

Methods: The team used value stream mapping to identify processes needing improvement. Improvement activities addressed the initial processing of a request, provider signature on the form, returning the form to the sender, and uploading the completed documents to the electronic medical record. Data on lead time (time between receiving a request and sending the completed request to the Health Information Management department) and process time (amount of time the staff worked on the request) were collected via manual pre- and post-time studies.

Results: Following implementation of interventions, the median lead time for processing durable medical equipment and supply requests decreased from 50 days to 3 days (p < 0.0001). Median processing time decreased from 14min to 9min (p < 0.0001). The decrease in processing time realized annual cost savings of approximately $11,000.

Conclusions: Collaborative leadership and multidisciplinary training in Lean methods allowed the CCC staff to incorporate common sense, standardize practices, and adapt their work environment to improve the timely and reliable provision of equipment and supplies that are essential for their patients.

Implications: The application of Lean methodologies to processing requests for DME and supplies could also result in a natural spread to other paperwork and requests, thus avoiding delays and potential risk for clinical instability or deterioration.

Keywords: Durable medical equipment; Improvement; Lead time; Lean methodologies; Process time.

MeSH terms

  • Cost-Benefit Analysis
  • Durable Medical Equipment / statistics & numerical data
  • Durable Medical Equipment / supply & distribution*
  • Durable Medical Equipment / trends
  • Efficiency, Organizational / standards
  • Efficiency, Organizational / statistics & numerical data
  • Humans
  • Pediatrics / methods
  • Pediatrics / trends
  • Quality Improvement
  • Total Quality Management / methods*
  • Total Quality Management / statistics & numerical data