Improvement of Cancer Treatment Processes and Reduction of Cost and Patient Length of Stay in Hospital

Background: Reducing patient length of stay (LOS) in hospitals reduces the high cost of chemotherapy and increases patient satisfaction. Objectives: This study aimed to present a combined model based on value engineering and the house of quality (HOQ) to improve the chemotherapy processes of hospitalized adult patients and reduce LOS and costs. Methods: In this study, a cost and time model of the functions was drawn for the current chemotherapy process, and as a result, the duration and costs of a chemotherapy course were obtained. A simulation model corresponding to the process map was developed and the output was validated. Afterward, using the HOQ method in the pre-study stage and collecting value engineering information, the real needs and wants of patients were transformed into quality characteristics, and by implementing other value engineering steps, 5 scenarios were presented to improve the process and were tested on the validated simulation model. Results: The presented scenarios included the process scenario (17.29% time reduction and $ 537,827 cost reduction), medication delivery scenario (7.3% time reduction and $ 268,231 cost reduction), technology scenario (2% time reduction and $ 59,640 cost reduction), end-of-life scenario (20% reduction in time and no cost savings), home care scenario (14% reduction in time and $ 329,020 cost reduction). Conclusion: By implementing these scenarios and improving the process, the treatment protocol was changed and caused an increase in the value index of the patient's LOS and a decrease in the waiting list for chemotherapy in the above hospital.