Towards a Lean Process for Patient Journey Mapping - A Case Study in a Large Academic Setting.

Hospital quality improvement initiatives that focus on the patient experience are increasingly gaining attention. One of the known improvement methodologies is patient journey mapping. Central to this methodology is the mapping process, resulting in a patient journey map: a visual presentation of the complete route a patient follows during all stages of a care trajectory and the patients emotional experience during this journey: the patient journey map. Currently, there is no standard approach on how to perform the steps in the mapping process and evidence is lacking on the most effective and efficient way. As a result, the adoption of the methodology by healthcare professionals is hindered, more time than necessary is spent on the mapping and a lot of significant variation exists in the quality of the resulting patient journey maps. The Lean methodology has a proven track of record to optimize and standardize processes. Hence, by performing a Lean analysis onto the patient journey mapping process, opportunities to optimize and standardize the process may be identified. This study aimed to assess the value of Lean methodology to optimize patient journey mapping in a hospital setting. Observations and interviews were performed to identify the process for patient journey mapping in a Dutch academic hospital. Lean was used to visualize the process and identify inefficiencies. An expert panel reviewed the improvement suggestions. We conclude that Lean can provide value for aligning different views on the process, for structuring the process steps and phases and for identifying optimization actions in the mapping process.