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Clin Respir J. 2012 Jul;6(3):169-74. doi: 10.1111/j.1752-699X.2011.00271.x. Epub 2011 Nov 15.

The Lean method as a clinical pathway facilitator in patients with lung cancer.

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Heart and Lung Clinic, University Hospital of North Norway, Tromsø, Norway.



Patient flow during workup for lung cancer is often difficult to influence because of delay at many levels: patient delay, doctors' delay and waiting time for X-ray and CT scan, referral to specialist, and waiting time for chemotherapy and radiotherapy or surgery. A mean workup time of 4 months is not unusual.


To improve quality and shorten the workup time for patients with lung cancer.


It was decided to employ a program designed by the Toyota car industry, the Lean process, as a tool to improve workup time. A Lean process implicates all levels of an institution with project and focus groups having workshops to analyse present status and suggest improvements.


Since introducing the Lean project, we have decreased the workup time from a mean of 64 days to 16 days, and the median time from diagnosis to surgery was reduced from 26.5 days to 15 days.


It is feasible to improve patient flow for patients with lung cancer by employing the Lean method as a pathway instrument.

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