Problem Statement:
Long wait times for healthcare services with an average wait time of 45 minutes in Philippine hospitals contributes to overcrowding and poor patient experience.
Problem Elaboration:
• Delays in treatment lead to decreased patient safety and low, quality care resulting in patient death and permanent loss of function. Delay of treatment leads to slow recovery of patients.
• Overcrowding persists in Philippine hospitals. Overcrowding causes problems of dysfunction. It is connected with longer waiting times (45 minutes), delays in admission, and even with transmission of diseases. Longer waiting time has an effect on other hospital processes, such as the admission of patients and the various lab tests to be performed.
• There are about 90 million people living in the Philippines. Many do not have access to basic care. Healthcare suffers from a shortage of medical resources and doctors. Thus, the system operates at a slower pace and operates less efficiently.
• Delay of treatment leads to operational inconveniences resulting in high patient dissatisfaction, with many complaints about the long duration of time spent in the waiting room.

Citations:
Heuvel, Jaap & Does, Ronald & De Koning, Henk. (2006). Lean Six Sigma in a hospital. Int. J. Six Sigma and Competitive Advantage Int. J. Six Sigma and Competitive Advantage. 2. 377-388. 10.1504/IJSSCA.2006.011566.
Romualdez Jr., Alberto G., dela Rosa, Flavier, et al. (2011). The Philippines Health System Review. World Health
Organization. Vol. 1. No. 2.

Thesis Statement:
In order to reduce long waiting times, the appointment processes in hospitals need to be reengineered through the implementation of Lean Six Sigma.
Thesis Elaboration:
• Lean Six Sigma implementation reduces the waiting time and improves the process performance.
• Implementing the Lean Six Sigma technique also increases process improvement to ensure the positive results are sustained in the long term.
• The application of Lean Six Sigma will show that current practices and
existing process flows of selected hospitals require redesigning.

Citations:
Health Service Delivery Profile: Philippines. (2012). World Health Organization and Department of Health, Philippines.
Henshall, Adam. (2017). DMAIC: The Complete Guide to Lean Six Sigma in 5 Key Steps.

Research Questions:
• How can Lean Principles be synthesized with the Six Sigma methodology for process performance and improvement in waiting times for healthcare services?
• How can the reasons for hospital overcrowding that affects patient flow in
emergency rooms and selected departments be determined?
• How can inefficiencies and administrative waste, which impacts patient flow, patient experience and quality of health care services in hospitals be identified?
• What strategies are being implemented to reduce wait times and improve patient flow functions in hospitals based on Lean Six Sigma?
• How can the desired results of incorporating the Lean Six Sigma for improving
waiting times be assessed for operational effectiveness?
Research Objectives:
• To combine Lean Approaches with the Six Sigma methodology for process
performance and improvement in wait times for healthcare in Philippine hospitals.
• To collect the data in order to discover the reasons for overcrowding that impacts patient flow in emergency rooms and selected departments.
• To analyze Lean Six Sigma methodology by means of flowcharting to improve the
steps, to identify inefficiencies and administrative waste.
• To design baseline metrics that utilize Lean Six Sigma thereby boosting continuous process performance and process improvement in hospitals.
• To implement an effective evaluation methodology that measures the 3

Hypotheses
Hypothesis # 1: The average percentage of patient waiting times will be improved
by at least 10% through the application of Lean Six Sigma methods.
Independent Variable: Lean Six Sigma approaches
Dependent Variable: Patient wait times
Testable: Experiments can be conducted, and data can be collected on waiting
times in selected departments within selected Philippine hospitals.

Hypothesis # 2: The average percentage of patient waiting times will be improved by at least 10% through how the front desk receptionists distribute the workload.
Independent Variable: Selected front desk receptionists
Dependent Variable: Patient waiting times
Testable: Observations can be done on front desk receptionists and data can be collected on waiting times.

Hypothesis # 3: The average percentage of patient waiting times will be improved by at least 10% by reducing the gaps between healthcare service appointments.
Independent Variable: Healthcare service gaps Dependent Variable: Patient waiting times
Testable: Healthcare service gaps can be analyzed, and data can be collected on waiting times.

Problem Statement: Long wait times for healthcare services with an...