Operational Process Improvement for Outpatient Services at a Private Medium-Sized Hospital


  • Tanat Ngaorungsi Chulalongkorn University
  • Parames Chutima Chulalongkorn University; The Royal Thai Society, Thailand




healthcare, process improvement, simulation modelling, visual management, Lean


This study is dedicated to enhancing the efficiency and efficacy of a medium-sized community hospital's services, which have limited space and experience a high volume of visits from diverse patient types with distinct service processes. The hospital challenges meeting the waiting time Key Performance Indicator (KPI) primarily from internal factors. The research methodology involves a comprehensive approach, encompassing the collection of qualitative and quantitative data, interviews with hospital staff, on-site observations, and a detailed examination of processing times at each step within the outpatient department. Upon data analysis, the study identifies and categorises key issues within the current Outpatient Department (OPD). These issues are encapsulated in three main categories, i.e., the unavailability of doctors during critical periods, insufficient staff for document delivery, and ineffective communication. Addressing the imperative of minimising patient system dwell time, a key competitive objective in the healthcare sector, this article is dedicated to identifying and implementing tools within a Lean framework. Tools such as root cause analysis, Poka-Yoke, and visual control are identified and implemented to optimise outpatient operations. Using simulation software, quantitative data is utilised to simulate and evaluate the outpatient process. The simulation results underscore significant periods during which doctors are absent, and an imbalance in workforce distribution emerges as a bottleneck. From a Lean perspective, recommendations are formulated to address these issues, emphasising the need for schedule balancing and minimising batch size through a proposed document method. The efficacy of these recommendations is subsequently validated using the simulation models. Through a series of optimisations and experiments, the average time in the system of social security patients has demonstrated a noteworthy reduction from 1,999 seconds to 1,820 seconds, reflecting an 8% improvement.


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Author Biographies

Tanat Ngaorungsi

Regional Centre for Manufacturing Systems Engineering (RCMSE), Chulalongkorn University, Thailand

Parames Chutima

Regional Centre for Manufacturing Systems Engineering (RCMSE), Chulalongkorn University, Thailand

Department of Industrial Engineering, Faculty of Engineering, Chulalongkorn University, Thailand

The Academy of Science, The Royal Thai Society, Thailand


Published In
Vol 28 No 2, Feb 29, 2024
How to Cite
T. Ngaorungsi and P. Chutima, “Operational Process Improvement for Outpatient Services at a Private Medium-Sized Hospital”, Eng. J., vol. 28, no. 2, pp. 29-65, Feb. 2024.

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