Lean Management Improves the Process Efficiency of Controlled Ovarian Stimulation Monitoring in IVF Treatment
Table 3
Results of waste identification in COS service processes in Yasmin Clinic.
No.
Waste category
Problem
1.
Defect
(i) Drug supply sometimes runs out; therefore, patients should search for drugs outside the hospital (ii) Incomplete and unreadable medical records (iii) Simultaneous data input into multiple tabs using the available online systems is not possible (iv) The tubing system for speedy delivery of files from laboratories and pharmacies was broken
2.
Overproduction
(i) Inefficient patient registration flow because IVF patients have to register on the ground floor and confirm registration to the administration on the fourth floor of the Yasmin Clinic (ii) Patients were called repeatedly because they were waiting in different places (iii) Rewrite results that are already in the medical record
3.
Waiting
(i) Patients must wait for doctor’s arrival (ii) Waiting for medical intervention (drug injection or blood sampling) (iii) Waiting for additional examination results (laboratory result) (iv) Waiting for data input into the online system (v) Waiting for prescription input into the online system (vi) Patients must wait for drugs preparation because they can coincide with patients from other clinics in RSCM
4.
Nonutilized personnel
(i) Limited number of nurses take blood samples, causing long queues (ii) Limited number of nurses in the injection room
5.
Transportation
(-)
6.
Inventory
(-)
7.
Motion
(i) Administration office and examination room are located on different floors (ii) Laboratory and the consultation room are located on different floors (iii) The nurses go back and forth to provide information to the previous patient and call the next patient at the same time (iv) The pharmacy and the consultation room are located on different floors
8.
Extra processing
Estradiol laboratory test on every visit
IVF: in vitro fertilization; RSCM: Cipto Mangunkusumo General Hospital; (-): no problem.
