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News By: Planet Lean

LIA helping Gauteng hospitals get lean

NEWS - The Guateng Department of Health and Lean Institute Africa have initiated a program to improve staff efficiency and reduce patient waiting times in provincial hospitals.


- This article was first published by eHealth News in South Africa; the original version (available here) has been partially edited -


The Gauteng Department of Health (GDoH), in collaboration with the Lean Institute Africa (LIA), has initiated a program to improve staff efficiency and reduce patient waiting times in provincial hospitals.

According to Chairman of the LIA, Prof Norman Faull, the initiative began in November 2014 when the GDoH approached the LIA after reviewing the success of their previous Lean Management Improvement seminars financed by the NDoH between 2010 and 2011 in 18 hospitals across the country.

The GDoH awarded the LIA a contract to roll out their lean workshops in 36 hospitals, starting with phase one that includes Chris Hani Baragwanath Academic Hospital, Leratong Hospital, Sebokeng Hospital and Kopanong Hospital.

According to Gauteng MEC for Economic Development, Qedani Mahlangu, the main driver of the lean project was to eliminate wastage in healthcare facilities. "In collaboration with the LIA, we have been able to identify areas in which wastage must and can be eliminated. Closely linked to this is another driver, which is streamlining processes in the chain of a patient's journey at any one of our facilities. This is to improve the experiences of patients as well as enhance the overall productivity of our hospitals and clinics," said Mahlangu.

Prof Faull explained that long patient waiting times in the hospitals were a result of inefficient patient file management. "In Leratong Hospital the patient folders are stored in a designated windowless underground storage room. The retrieval method involves workers on the night shift finding the patient folders according to a booking list for patients expected the next day. It's an extremely long process, and 20-30% of the time patients don't even arrive, which means time is wasted having to put the folders back again," said Prof Faull.

Prof Faull went on to explain that through an experiment they conducted as part of their lean initiative, instead of retrieving the folders in advance they waited for the patient to come to the counter and then retrieved the folders in smaller batches by using computers to send folder retrieval messages down to the storage room. "The patient journey used to average 143 minutes, after our intervention it was less than 40 minutes," said Prof Faull.

Mahlangu added that there have been significant reductions in waiting times at both the pharmacy and theater of Charlotte Maxeke Hospital since following the lean approach. "There has been a 22 minute improvement in waiting time for long scripts and the average waiting time for short scripts has been reduced to 5.2 minutes. About 45% of medications are received immediately at the express script-check window and 33% of patients with express scripts are served in less than three minutes," said Mahlangu.

With regard to the theater, Mahlangu said 70% utilization has been achieved resulting with 32 more short cases every month. "For the first time, there has been an electronic single source of data on daily theater performance at Charlotte Maxeke. This is a massive improvement that has a direct impact on people's lives and their productivity. We will be implementing this project across our major health facilities in the Province in an effort to reduce overall waiting times," said Mahlangu.

In-line with Prof Faull's belief that lean management is the "pre-automation to eHealth," Mahlangu supports the Gauteng Premier's commitment to transforming and modernizing the provincial healthcare system with eHealth as being the next step. "It is imperative that we modernize our healthcare system in such a way that enhances administrative efficiency and patients' experiences at our facilities. The GDoH will therefore create a complete eHealth record for every patient," said Mahlangu.

According to Mahlangu, this is hoped to be achieved through an extensive upgrade of ICT infrastructure and the broadband network within the Province; scanning and indexing of every patient record which will be stored within data repositories that will allow patient information to be viewed between facilities; and the roll out of the Picture Archiving Communication System (PACS) to eliminate the physical transfer of x-rays between facilities.

"Implementation of the eHealth programme will increase interconnectedness between healthcare facilities in Gauteng, eliminate of the use of paper by capturing of patients' records into an electronic system, and as a result reduce waiting times and ultimately improve the patient journey from start to finish," concluded Mahlangu.


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