title: Improving the efficiency of a chemotherapy day unit: applying a business approach to oncology.
abstract: OBJECTIVE
  To improve the efficiency of a hospital-based chemotherapy day unit (CDU).
  
  
  METHODS
  The CDU was benchmarked with two other CDUs to identify their attainable performance levels for efficiency, and causes for differences. Furthermore, an in-depth analysis using a business approach, called lean thinking, was performed. An integrated set of interventions was implemented, among them a new planning system. The results were evaluated using pre- and post-measurements.
  
  
  RESULTS
  We observed 24% growth of treatments and bed utilisation, a 12% increase of staff member productivity and an 81% reduction of overtime.
  
  
  CONCLUSIONS
  The used method improved process design and led to increased efficiency and a more timely delivery of care. Thus, the business approaches, which were adapted for healthcare, were successfully applied. The method may serve as an example for other oncology settings with problems concerning waiting times, patient flow or lack of beds.
authors.affiliation: Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. wamvanlent@gmail.com
authors.forename: Wineke A M
authors.initials: WA
authors.lastname: van Lent
authors.forename: N
authors.initials: N
authors.lastname: Goedbloed
authors.forename: W H
authors.initials: WH
authors.lastname: van Harten
mesh_terms: D001509:Bed Occupancy / Q000706:statistics & numerical data; D019985:Benchmarking; D002173:Cancer Care Facilities / Q000458:organization & administration / Q000592:standards; D003695:Delivery of Health Care / Q000458:organization & administration / Q000592:standards; D017598:Efficiency, Organizational; D006302:Health Services Research / Q000379:methods; D006801:Humans; D009369:Neoplasms / Q000188:drug therapy*; D009426:Netherlands; D016522:Oncology Service, Hospital / Q000458:organization & administration* / Q000592:standards; D010044:Outpatient Clinics, Hospital / Q000458:organization & administration* / Q000592:standards; D010347:Patient Care Planning / Q000458:organization & administration; D017749:Total Quality Management