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Applying “lean” principles to improve hospital chemotherapy services

By Jon Beard and Jarrod Dunn



To address deficiencies in chemotherapy production and improve co-ordination between production, prescribing and clinic scheduling.


Service review and redesign using ‘lean’, change management techniques.    


An oncology unit at a district hospital.     

Outcome measures

Daily production run times and associated patient delays.


Production run times fell from 4.07h (sd=0.52h) to 2.82h (sd=0.44h), representing a weekly reduction of approximately 31.25h of staff time. The number of treatment delays of over an hour decreased from 50% or more to under 5% (one or two instances per day), due predominantly to most chemotherapy being prepared the day before scheduled treatment. Medical, nursing and production staff concurred that the changes were positive.


Systematic interventions designed to reduce wasteful activity, combined with co-ordinated activity rescheduling, reduced production run times and patient waits while reducing staff costs.

Citation: The Pharmaceutical Journal URI: 11106231

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