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Presented By

F ikry
A gag
H ala
M ohammed
Value Or Waste

180 Seconds?
180 second

• Cataract operation in Aravind

You don’t have to be a '’religious’’ person
to serve God.
You serve God by serving humanity.

Dr. Govindappa Venkataswamy

Dr. V.
Aravind Eye Hospital
About Lean Managment

is a systematic method for waste minimization within a Healthcare

system without sacrificing productivity.

Before They were using nurses not graduated from nurse school or
collage so they were doing mistakes and ask help from the
old nurses which making patient wait.

They trained there nurse staff and send others to

learn in high collages to be professional at there
After work also they increased their doctors and nurse

Before the operating theater appeared crowded and cramped which

can hold on operations and lead to much time waiting.

They made charts to organize there work and also

doctors used some of his relatives who were
educated at high collages at USA to arrange the
hospital for infection control and quality
After management so operations time became 10-15
minutes and they increased their operations rate
and arranged their operation theater.
Extra Processing

There are more than one skilled professional doctors doing one operation
at same time while many patients were waiting there turn .

They made a flow charts for doctors and there working area so
every professional doctor and his staff to avoid extra processes
problem and cover all patients without waiting.
Extra Processing
Patients have to pass more than four doctors to reach the surgeon for there
operation while only 2 professional doctors could do what is needed.

They made flow chart for doctors who working at hospital to

arrange there work and detect waste process
Waiting (OPD)
Patient flow from the Ophthalmic assistant to the eye doctor then to
Ophthalmic assistant again.

The patient first go to Ophthalmic assistant to record each perso

n’s vision then moved to the next room for a preliminary eye exa
mination by an eye doctor.
There were several eye doctors on duty, and ophthalmic assista
nts noted the preliminary diagnosis on the patient’s medical rec
ord. Ophthalmic assistants then tested patients for ocular tensio
n and tear duct function, followed by refraction tests. The final e
xamination was always conducted by a senior medical officer.
Waiting (OR)
On the day of the surgery, all patients were usually awakened
early and after a light breakfast prepared for surgery.

On a visit to the operating theater, I noticed about 20

patients seated in the hallway, all appropriately prepared by the
medical staff to enter into surgery, and another 20 in the
adjacent room in the process of being readied by the nursing
staff. The procedure involved cleaning and sterilizing the eye and
injecting a local anesthetic. The operating theater had two active
operating tables and a third bed for the patient to be prepared
prior to surgery
Non Utilized Taelnt

Using unspecialized and unqualified nurses

& receptionists

Hire new nurses and workers and give them

courses and send them outside to get degrees
Non Utilized Talent
Support the staff to advice their own village
people to screen or and follow
To much transportation from village to another and from camp to hospital

Bus trips were so organized that individuals from the s

ame or nearby villages were always clustered in the sa
me bus trip, which reduced the need for anyone to acc
ompany the patients. They were all returned together
after three or four days. This established a support gro
up during their recovery phase. A team from Aravind
returned for follow-up after three months.

Not all patients need to pass through every step.

Those referred to
specialty clinics (such as retina and vitreous diseases)
would directly move to the specialty section of the
hospital on the first floor. Similarly, patients diagnosed as
needing only corrective lenses would move to the optom
etry room for measurement and prescription of glasses.
At the Free Hospital, detailed records were kept of
all post-operative complications.

Some complications, such as iritis, were considered minor and

easily treatable, while others required extra care and additional
hospital stay. Such complications were directly traced to the
operating team, even to the level of the individual surgeon. Senior
medical officers reviewed the data with the individuals concerned
and offered coaching and advice to rectify operating techniques, if
• Receiving money from rich patients

The sponsor not only paid all the publicity costs

but also the direct costs associated with organizing the ca
mp patient transportation, food, and aphakic glasses.
In addition, the sponsors also paid for the costs
of transporting, feeding, and bringing back the patients sel
ected for surgery.

• Local manufacturing of lens with low cost