4.0 Article

Improvement of Cancer Treatment Processes and Reduction of Cost and Patient Length of Stay in Hospital

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ZAMENSALAMATI PUBL CO
DOI: 10.32592/ircmj.2022.24.9.1948

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Cancer; Cost evaluation; House of quality; Length of stay; Simulation; Value engineering

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This study presents a combined model based on value engineering and the house of quality to improve the chemotherapy processes of adult patients. By implementing different scenarios, the study successfully reduces the time and cost of chemotherapy and increases the value index of patient's length of stay.
Background: Reducing patient length of stay (LOS) in hospitals reduces the high cost of chemotherapy and increases patient satisfaction. Objectives: This study aimed to present a combined model based on value engineering and the house of quality (HOQ) to improve the chemotherapy processes of hospitalized adult patients and reduce LOS and costs. Methods: In this study, a cost and time model of the functions was drawn for the current chemotherapy process, and as a result, the duration and costs of a chemotherapy course were obtained. A simulation model corresponding to the process map was developed and the output was validated. Afterward, using the HOQ method in the pre-study stage and collecting value engineering information, the real needs and wants of patients were transformed into quality characteristics, and by implementing other value engineering steps, 5 scenarios were presented to improve the process and were tested on the validated simulation model. Results: The presented scenarios included the process scenario (17.29% time reduction and $ 537,827 cost reduction), medication delivery scenario (7.3% time reduction and $ 268,231 cost reduction), technology scenario (2% time reduction and $ 59,640 cost reduction), end-of-life scenario (20% reduction in time and no cost savings), home care scenario (14% reduction in time and $ 329,020 cost reduction). Conclusion: By implementing these scenarios and improving the process, the treatment protocol was changed and caused an increase in the value index of the patient's LOS and a decrease in the waiting list for chemotherapy in the above hospital.

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