Extending Sustainable Value Stream Mapping to Hospital Environments: An Empirical Study of Surgical Process Improvement

BACKGROUND AND OBJECTIVES: Lean production techniques have been widely adopted in manufacturing to reduce waste, optimize processes, and improve efficiency. With the rising focus on sustainability across economic, environmental, and social dimensions, attention has turned to healthcare settings. However, the application of Sustainable Value Stream Mapping (Sus-VSM) in hospitals remains relatively unexplored. METHODS: This study addresses that gap by implementing a Sus-VSM approach in the preoperative and postoperative phases of 3 surgery types: general surgery, urology, and obstetrics at a major hospital. We collected 6 months of operational data, identifying key inefficiencies. A current-state VSM was created, followed by Lean-based interventions including 5S, visualization, and forecasting. RESULTS: Results revealed an 11.5% reduction in anesthesia paperwork time and improved bed-management planning. Additionally, we evaluated the hospital's economic, social, and environmental performance using adapted metrics. Findings indicate particularly high social sustainability (97.85%), moderate environmental performance (77.6%), and an 80.2% economic rating. CONCLUSION: By integrating triple-bottom-line principles with Lean thinking, this study presents a structured methodology for advancing both operational efficiency and institutional sustainability in healthcare. These findings support the broader adoption of Sus-VSM and point to the need for life-cycle assessments and longitudinal research to validate long-term impacts on healthcare delivery.