Improving patient flow with LEAN and TOC

Dirk Ralfs
17 april 2025

Hospitals often face a delicate balancing act between maintaining high-quality care and achieving cost-effectiveness. Anyone working in inpatient care is familiar with the issue: small inefficiencies quickly accumulate, leading to significant bottlenecks that burden both patients and staff.

Many hospitals struggle with staff shortages. Nurses and doctors face intense daily pressure as they navigate high patient volumes, complex processes, and administrative overload. Valuable time is lost due to missing information, delayed diagnostics or treatments, and time-consuming bureaucratic tasks. The result? Patients remain hospitalized longer than medically necessary, while staff operate constantly at their limits.

How Can LEAN and TOC Help?

By combining LEAN management (focused on eliminating waste) with the Theory of Constraints (TOC) (targeting and resolving process bottlenecks), hospitals can quickly and reliably achieve measurable improvements.

Why Focus on Inpatient Care?

Unlike emergency or outpatient settings, inpatient care involves patients who are already admitted and depend on the hospital’s internal organization. Delays in diagnostics or treatment extend hospital stays unnecessarily. For clinical staff, this means increased workload and stress.

Common challenges Include:

  • Delays in diagnostics and therapy, leading to unnecessarily prolonged stays
  • Unclear or late communication between departments, resulting in time lost
  • Inefficient resource allocation, increasing the burden on staff
  • Excessive administrative tasks that take time away from direct patient care

LEAN and TOC offer systematic approaches to eliminate these inefficiencies.

LEAN: Streamlining Processes and Reducing Waste

LEAN improves inpatient workflows by eliminating non-value-adding activities. Key areas of improvement include:

  • Improved ward rounds – Timely decisions regarding diagnostics, treatment, and discharge
  • Standardized communication – Wards are informed about upcoming patient appointments; tests, treatments, and transports are well coordinated
  • Reduced bureaucracy – Simplified documentation and digital workflows ease administrative burdens

TOC: Identifying and Resolving Bottlenecks

While LEAN reduces inefficiencies across the board, TOC focuses on the most critical constraints in patient flow. In inpatient care, typical bottlenecks include:

  • Delays in diagnostics, such as long wait times for radiology or cardiology
  • Limited resource availability, such as temporary loss of physiotherapy services
  • Staff shortages in key roles, causing operational slowdowns

By targeting these core issues, TOC drives rapid improvements with maximum impact.

The Qareon Methodology: A Combined Approach for Lasting Results

The Qareon Methodology integrates LEAN and TOC to strategically optimize processes around the most significant patient flow bottlenecks.

Example: increasing efficiency in radiology

At one hospital, patients faced long wait times for MRI appointments, despite unused MRI capacity. Patients often arrived late and unprepared, due to poor coordination between radiology and the wards.

  • Wards were unaware of MRI appointment times and were caught off guard when transport services arrived.
  • Patients were unprepared, delaying transport or requiring additional preparation in radiology.
  • Valuable MRI capacity went unused, and treatments were delayed due to postponed diagnostics.

How was the bottleneck resolved?

  • Wards were trained to monitor upcoming appointments, ensuring timely use of diagnostic resources and reducing patient wait times.
  • Standardized preparation protocols ensured patients were ready for imaging procedures.
  • A MRI coordinator tracked appointment delays and monitored patient flow regularly.

The results?

  • MRI delays dropped from the top three causes of treatment delay
  • On average, four fewer beds were occupied daily by patients awaiting MRI scans
  • Average length of stay decreased accordingly

These improvements were achieved within a few months, without additional staffing or investment in new equipment—thanks to the Qareon approach.

How Can InnoQare Support Your Hospital?

Does your hospital struggle with prolonged stays, staff shortages, or recurring process disruptions? Our tool-based optimization program can help.

The Qareon Methodology is designed to identify and systematically remove bottlenecks in patient flow. This reduces length of stay and eases pressure across the hospital.

Let’s explore how your hospital can benefit. Get in touch with us today.