Value Stream Mapping in Lean Healthcare: A Brief Introduction and Application

The Lean approach espouses the elimination of sources of waste throughout a process, so that only value-added activities that address the desires of the customer should be implemented. Originating in manufacturing, Lean has been applied to healthcare, being used to address waste in this sector, for the benefit of patients and other healthcare actors. A central technique for identifying sources of waste is value stream mapping. This technique involves the creation of diagrams that depict workflow and its associated waste, and future state processes with waste reduced or eliminated, all occurring within an overarching series of activities that sees process improvements implemented. This chapter highlights the creation and use of value stream maps (VSMs) in the context of a Lean Healthcare initiative. A case example proposes current state and future state VSMs for medical coding and billing processes, which entail the capture of patient encounter information by the physician for the purpose of receiving remuneration from a healthcare system payer.