Value Stream Map Assessment Of The Extended Day: 23h Surgery Model

Healthcare (HC) environments demand high-quality design in order to provide efficient care processes for those in need. In this study, we aimed to determine changes in the target hospital's (H1) operative processes undergoing relocation. The goal was also to illustrate the shift in treatment paradigm from bedside care to extended day surgery, and the burden in terms of bedside places and anesthesia and surgery processes. Value stream mapping has been utilized to assess both the hospital work environment and work process design. The significant improvements in H1 process design include improved treatment planning, minimization of patient stay at the hospital, centralization of patient care and focus on Lean thinking. The value stream maps created in 2016 appeared more complicated compared to those composed in 2013. Several reasons may explain the complexity of the value stream maps: Surgical care has gained new alternative treatment options, patient pre-evaluation is carried out comprehensively before the surgery and phone contacts, local municipality research resources are utilized, anesthesia evaluation is carried out systematically and patients' diseases are optimized to fit the surgery schedule. We argue that in a HC context, more complex value stream maps may not always be inferior compared to simpler ones.