Reducing Waiting Time and Impact on Anxiety in Radiotherapy: Evaluation of a Lean Intervention Focused on Patient Experience

Introduction: Radiotherapy, while central to the management of many cancers, is often accompanied by significant psychological stress. Among the organizational factors that may exacerbate this anxiety, waiting time before treatment sessions is frequently overlooked. This study aimed to assess the impact of a Lean approach on reducing waiting times in radiotherapy and its effect on patient anxiety. Methods: A before-and-after observational study was conducted in the radiotherapy department of CHU Hassan II in Fez. Two six-week periods were compared: pre-Lean intervention (n = 135) and post-Lean intervention (n = 115). Waiting time was defined as the interval between arrival in the waiting room and entry into the treatment room. Anxiety was assessed using the HADS-A scale. The Lean intervention included care process mapping, identification of delay sources, implementation of individualized treatment slots, and a centralized digital workflow system. Results: The study population (n = 250) had comparable sociodemographic and clinical characteristics across both periods. Following the intervention, the average waiting time was reduced from 120 to 30 minutes (−75%). This organizational improvement was accompanied by a significant decrease in average anxiety scores (from 9.4 to 7.9), particularly among patients under 60 years old, those who were employed, accompanied, urban residents, and those with localized cancers. In multivariate analysis, alongside the reduction in waiting time, the presence of a companion remained significantly associated with lower anxiety scores. Conclusion: The Lean approach applied to radiotherapy care organization significantly reduced perceived waiting times, with a measurable positive effect on patient anxiety. These findings highlight the value of patient-centered quality improvement initiatives in enhancing both organizational efficiency and psychological well-being in oncology.