Long wait times and low resource utilisation are the most critical issues in treatment-oriented outpatient departments. While Lean has been utilised to resolve similar issues in healthcare, the literature provides no structured means of implementing Lean in outpatient departments. This study establishes a Lean transformation framework to identify a balanced patient demand by determining proper patient compositions, to schedule non-specialists to increase resource utilisation, and to level patient schedule throughout the day to reduce wait times. This framework includes a series of activities and Lean tools that are specifically adapted for use in outpatient departments. A case study is presented to illustrate the implementation of the proposed framework and its possible impacts, using data from a community hospital oncology department in Montreal, Canada. Results suggests that this framework reduces patient visit time by 36% and increases daily treatments by 39% and utilisation of chemotherapy chairs by 22%, with a possibility to implement a one-day treatment regime. The proposed framework can assist treatment-oriented outpatient departments to overcome their operational challenges and to serve as an effective guideline in their Lean transformation.

等待时间长和资源利用率低是面向治疗的门诊部门最关键的问题。虽然精益技术已用于解决医疗保健中的类似问题，但文献并未提供在门诊部实施精益技术的结构化方法。这项研究建立了一个精益转换框架，通过确定合适的患者组成来确定平衡的患者需求，安排非专家安排以增加资源利用，并整日安排患者安排以减少等待时间。该框架包括一系列活动和精益工具，专门用于门诊部门。利用蒙特利尔社区医院肿瘤科的数据，进行了案例研究，以说明拟议框架的实施及其可能产生的影响，加拿大。结果表明，该框架将患者就诊时间减少了36％，将每日治疗量增加了39％，将化学治疗椅的使用量增加了22％，并且有可能实施一日治疗方案。拟议的框架可以帮助以治疗为导向的门诊部门克服其运营难题，并成为其精益转型的有效指南。