Time is of the Essence: Value Stream Mapping a National Health Service (NHS) Emergency Department in the South West of England

Charting the progression of time is hugely important in Healthcare environments. Time is of the essence when patients' lives are at stake if they do not receive timely medical intervention. Healthcare service providers, managers and flow coordinators are particularly concerned with understanding where delays occur in the healthcare service they provide, in order that those delays are improved and patients receive the best possible treatment as quickly as they can. To understand those delays a Lean improvement tool: Value Stream Mapping (VSM) has been applied to a NHS Emergency Department (ED) in the South West of England. This paper reports on the findings from that VSM research and particularly the use of the VSM visualisation. We highlight the issues of visualising patient waiting using the VSM approach and how this hugely important research area requires an improved VSM diagram to convey information to medical decision makers about patient delays.