Applying value stream mapping techniques to eliminate non-value-added waste for the procurement of endovascular stents
Introduction
Early initiatives carried out in industry to establish supply chain developing programs have shown that it is necessary to map value-adding processes. By eliminating non-value-adding (NVA) factors and creating an overall smoother process, products and services become more valuable to the consumer as well as more competitive to rivals on a market. These economic approaches are increasingly applied in numerous medical settings [1], [2], [3], [4], [5].
The car manufacturer Toyota was the first company to use value stream mapping (VSM) techniques to implement Lean concepts and tools. The purpose of VSM is to minimize waste that prevents a smooth, continuous flow of products and information throughout a value stream [6]. A value stream displays the set of activities (and their respective value) involved to create a product or provide a service. Value stream mapping can be defined as a lean manufacturing technique used to analyze the flow of materials and information currently required to forward a product or service to a consumer [7]. Using pencil and paper or computer assistance, visualization serves as a tool to convey information about processes and interactions, to understand complex relationships and to identify hidden waste. Table 1 depicts key facts on VSM.
Section snippets
Area of application and outline of an implementation plan of the value stream mapping technique
The VSM technique was applied at a university interventional radiology department to eliminate non-value-adding waste in the process of endovascular stent procurement.
The focus was set to endovascular stents. They account only for a small amount of overall items used (ca. 15%) while accounting for the majority of value (ca. 80%) processed during the medical intervention. There are various stent differences e.g. in size, length, material and functionality, thus rendering a voluminous and very
Creation of the current state value stream map
The current state VSM was created and graphically organized (Fig. 1), considering thirteen procedural steps (Table 5).
Assessment of the current state value stream map
An assessment of the current state VSM (Fig. 1) demonstrated that out of thirteen processes for the procurement of stents only two processes were genuine value-adding processes:
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The supplier of stents (process no. 1).
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The procedure of stent implantation (process no. 9).
Unnecessary
Discussion
One important factor in gaining control over an organization is to know and profoundly understand its basic processes. Faulty systems and processes, which may also induce medical errors, are certainly one of the reasons for rising health care costs [8], [9], [10]. Industrial engineering practices and economic work organization improvement techniques are increasingly applied in medical settings in general [11] as well as in Radiology [12]. Especially the Toyota Production System is frequently
Conflict of interest
There are no conflicts of interest to declare for this study. It was not financed by third-party funds.
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