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Utilizing lean tools to improve value and reduce outpatient wait times in an Indian hospital

Richard Miller (Operations Management, University of Dallas, Irving, Texas, USA)
Nirisha Chalapati (University of Dallas, Irving, Texas,USA)

Leadership in Health Services

ISSN: 1751-1879

Article publication date: 2 February 2015




This paper aims to demonstrate how lean tools were applied to some unique issues of providing healthcare in a developing country where many patients face challenges not found in developed countries. The challenges provide insight into how lean tools can be utilized to provide similar results across the world.


This paper is based on a qualitative case study carried out by a master’s student implementing lean at a hospital in India.


This paper finds that lean tools such as value-stream mapping and root cause analysis can lead to dramatic reductions in waste and improvements in productivity. The problems of the majority of patients paying for their own healthcare and lacking transportation created scheduling problems that required patients to receive their diagnosis and pay for treatment within a single day. Many additional wastes were identified that were significantly impacting the hospital’s ability to provide care. As a result of this project, average outpatient wait times were reduced from 1 hour to 15 minutes along with a significant increase in labor productivity.

Practical implications

The results demonstrate how lean tools can increase value to the patients. It also provides are framework that can be utilized for healthcare providers in developed and developing countries to analyze their value streams to reduce waste.


This paper is one of the first to address the unique issues of implementing lean to a healthcare setting in a developing country.



Miller, R. and Chalapati, N. (2015), "Utilizing lean tools to improve value and reduce outpatient wait times in an Indian hospital", Leadership in Health Services, Vol. 28 No. 1, pp. 57-69.



Emerald Group Publishing Limited

Copyright © 2015, Emerald Group Publishing Limited

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