Abstract:
Abstract: Simulation model is descriptive in nature, and mimics characteristics of a real system offering a
better understanding of the system performance. However, over the years, it has been adopted in hospitals for
improving healthcare processes and optimizing resources, but it has not been linked directly to the concept of
lean management. Despite public hospitals in Kenya focusing on improving structures, communication
technologies and adopting modern medical equipment, they have lagged behind in improving patients’
preferences in relation to the care pathway processes and utilization of the available resources effectively. This
paper reviews lean concept in healthcare, and how simulation can be adopted as a lean tool to improve patient
flow in Kenya’s public hospitals using the case study of a public hospital. The main waste identified in the care
pathway was long patient waiting times, where often, patients at consultation room one waited for 0.94hrs,
while for the pediatric room, the patient waiting time was as long as 0.64 hrs before they could consult the
clinical officers. In the laboratory, patients tended to wait for a period of 0.66 hrs before being tested. To
address these shortcomings, several processes were re-engineered using simulation model with a view of
optimizing patient flow processes and utilization of available resource. The re-engineered processes included
centralization of cash payment points, adoption of adjustable a capacity system for clinical officers, and
addition of more resources at specific cash payment points, which were linked to long waiting times. Moreover,
re-engineering was proposed for the filtering rooms and the laboratory to improve the patient flow.
