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Updated: Apr 5, 2026

Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide
Published on: January 15, 2017
Efficiency improvement in the stroke care process based on the Lean Healthcare approach
Francisco Cortés-Sevilla1, Gonzalo Sánchez-Barroso1, Jaime González-Domínguez1
1Engineering Projects Area, University of Extremadura, Badajoz, Spain.
Purpose:
Stroke care requires coordination among medical professionals and hospital management staff in a collaboratively developed process that must be continuously improved, as care time significantly reduces the patient's capabilities after the intervention. This article aims to quantify the efficiency improvement in the stroke care process based on a comprehensive Lean Healthcare approach.
Design/Methodology/Approach:
An ad-hoc, two-phase structured Lean intervention was validated by analysing nine years of data in a hospital as proof of concept.
Findings:
Mean reductions of between 2 and 4 min in key in-hospital time-based metrics were achieved for both types of strokes under study, resulting in improvements of up to 11.1%. These benefits demonstrated a statistically significant difference in mean pre- and post-Lean metrics.
Practical Implications:
The group of patients analysed post-Lean was not only managed with tissue plasminogen activator or thrombectomy in less time but also had lower disability degrees at entry and after three months, with the jump from three levels pre-Lean to a single level according to the modified Rankin score decreasing.
Social Implications:
It was concluded that a patient-centric continuous flow design significantly increases the likelihood of patient recovery.
Originality/Value:
This study offers new evidence that a patient-centric continuous flow design enhances recovery outcomes in hospital care. By applying Lean Healthcare principles to patient-centred process redesign, it links operational efficiency directly to clinical improvement. The findings provide a replicable framework for integrating process flow optimisation into quality assurance, positioning it as a driver of patient-centred excellence and overall performance.
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