Optimizing patient care with multiple sclerosis at Getafe Hospital

This case study addresses the implementation of Lean methodology at Getafe University Hospital, with the aim of improving care for patients with multiple sclerosis. Faced with the challenges of long waiting times and significant bureaucratic burdens, the hospital adopted Lean methodologies to optimize its care processes and reduce administrative burdens, allowing healthcare professionals to devote more time to direct patient care. Through tools such as the Obeya Room and value stream mapping, the hospital was able to transform its operational processes, generating significant results in terms of both efficiency and patient satisfaction.

Continuous improvement was a key pillar in this initiative, enabling the hospital not only to address operational issues but also to establish a culture of innovation and multidisciplinary collaboration, driving both efficiency and quality in healthcare services.

Getafe University Hospital: innovation, quality, and commitment

Getafe University Hospital is a leading public hospital in southern Madrid, part of the Madrid Health Service. Since its creation in 1991, it has worked tirelessly to provide quality, patient-centered healthcare, supported by a strong philosophy of continuous improvement, innovation, and excellence in all its services. With a multidisciplinary team of professionals and a commitment to teaching, research, and university training, the hospital focuses on constantly improving its assistance and care processes, adapting to the needs of patients and optimizing resources to ensure quality and safety in every service.

The core mission of the Getafe University Hospital is to provide quality healthcare based on scientific evidence, patient orientation, and active participation from both citizens and professionals. The hospital promotes innovation, multidisciplinary collaboration, and a human touch in every process. It views research, training, and professional development as essential pillars for ensuring the continuous improvement of the care provided.

The hospital aims to be a benchmark organization in patient care, distinguished by its accessibility, technology, scientific rigor, and sustainability. By investing in the work of multifunctional teams, the hospital ensures that the care provided is genuinely centered on the needs of the patients it serves.

Initial challenges to overcome

In 2017, the hospital identified several operational issues, the most notable being delays in patient care due to a high volume of administrative tasks. These tasks, which included ordering tests and scheduling follow-up consultations, negatively impacted service quality and patient satisfaction levels. The administrative burden primarily affected the management of consultations and tasks performed by the nursing team.

“Approximately 40% of consultation time was spent on bureaucratic tasks.” – Yolanda Aladro, Head of the Neurology Department, responsible for the Multiple Sclerosis Unit.

Implementation of Lean methodology

The hospital adopted Lean methodologies to transform its processes and address the main bottlenecks identified. Among the tools applied, the implementation of the Obeya Room stood out, a methodology that increased transparency and monitoring of projects proposed by different departments. The hospital had previously implemented the 5S methodology and the Kanban system, both with very positive operational results. Through the Obeya Room, it was possible to:

• Visualize improvement initiatives and share them across different services.
• Promote benchmarking, allowing other departments to replicate successful projects from other areas.

Figure 1 – Obeya Room at the Hospital

The Obeya Room has proven to be an effective tool at Getafe University Hospital, particularly due to its ability to promote transparency, collaboration, and continuous monitoring of improvement projects.

Optimizing patient care

To address delays in patient care, the intervention focused on improving the processes associated with consultations, using tools such as value stream analysis and the creation of multidisciplinary teams. The work involved the participation of healthcare professionals and external specialists, including a consultant from the Kaizen Institute and a member of the innovation department at Novartis.

Figure 2 – Example of consultation

The results from this phase were:

• 40% reduction in time spent on bureaucratic tasks, allowing the nursing team and doctors to focus more on direct patient care.
• Improvement in the accuracy of reports, which helped optimize the time dedicated to evaluating the patient’s condition.

Global results achieved with Lean methodology

By redesigning processes and adopting Lean methodologies, the hospital achieved the following results:

• Reduction in administrative burden: a 50% decrease in time spent on administrative tasks allowed healthcare professionals to dedicate more time to patient care.

“Now, with just one click, we can make all the necessary requests for the patient, reducing the administrative burden by 50%”— Yolanda Aladro, Head of the Neurology Department, responsible for the Multiple Sclerosis Unit.

• Reduction in admissions: with the new care circuit, both hospital and outpatient admissions decreased by 70%.
• Reduction in contrast-enhanced MRIs: a 50% reduction in the number of contrast-enhanced scans was achieved, without compromising diagnostic quality.
• Reduction in patients on waiting lists: a reduction of 80% was achieved, thanks to optimized processes that decreased waiting times, thus improving operational efficiency.
• Cost savings: an estimated annual savings of €12,524 were realized due to the reduction in time to initiate treatment.

Innovations in information management

The use of technology was also a key factor in improving efficiency. The integration of location systems into the electronic medical records allowed the hospital to track patients on waiting lists more effectively. This feature facilitated the scheduling of consultations and helped prevent delays, contributing to an overall improvement in service quality. The use of visual systems also played a relevant role in supporting more effective information management across the hospital.

Figure 3 – Examples of visual management

Impact on patient satisfaction

With the optimization of processes and improvements in care quality, the hospital was able to significantly increase patient satisfaction, both in terms of service speed and the accuracy of the care received. The focus on continuous improvement further reinforced the commitment and motivation of healthcare professionals, contributing to a better work environment.

“Now, we spend between 5% and 10% of consultation time on bureaucratic tasks.” – Yolanda Aladro, Head of the Neurology Department, responsible for the Multiple Sclerosis Unit.

Operational transformation and resource management improvement

The implementation of Lean methodologies in the hospital not only improved operational efficiency and reduced costs, but also had a direct impact on care quality. The ability to measure and adjust processes in real time was crucial to the success of the project. The adoption of tools such as the Obeya Room and the formation of multidisciplinary teams, combined with the involvement of all staff members, resulted in substantial improvements in resource management and the time dedicated to patient care.

“We chose Lean methodology because we believed it was an efficient model that helps us eliminate waste, resolve bottlenecks, and improve our processes.” – Zita Quintela González, General Director.

This case study demonstrates how continuous improvement, through the integration of Lean Management, can effectively transform healthcare delivery processes, reducing waiting times, increasing patient satisfaction, and optimizing resources in a high-demand environment.