Case Study

Lean Design Improvements Saves Hospital $1 Million

hospital money

Sustaining long-term results through a redesigned Cancer Center

A community hospital located in Colorado needed to address volume increases in its outpatient Medical Oncology Clinic’s treatment center while creating a collaborative, data-driven design to support efficient workflows, allow for growth and enhance the patient experience.

The Challenge

The San Juan Cancer Center at Montrose Memorial (Montrose, CO) included six exam rooms and ten infusion treatment stations. Originally, the Cancer Center capacity provided sufficient space to meet patient needs for chemotherapy treatments. Changing patient needs and increased volumes led to longer treatment times and overcrowding in the waiting area and filled treatment area capacity. In addition to needing a more operationally efficient space, Montrose wanted a flexible design, so the hospital could respond quickly to changes in care delivery in the future.

Montrose had recently completed its strategic and facility plans. The hospital reviewed its Cancer Center’s strategic plan, vision for the future, market demands, population health needs and physician and staffing resources. In planning for the renovation of the Cancer Center, Montrose’s leaders wanted a design that was cost effective and included flexibility for future expansion needs.

QHR Solutions

Montrose enlisted QHR to review the design of its outpatient medical oncology clinic and treatment area, using Lean principles. Lean facility planning and conceptual design includes a review of the facility plan design elements plus:

  • Detailed, data-driven analysis of current operations (systems, processes, flows, procedures and performance)
  • New system development to eliminate waste and simplify processes
  • Immediate savings opportunities from implementing recommended operational changes regardless of final design; Sustaining long-term results through a redesigned Cancer Center
  • Recommendations that result in the lowest cost/greatest longevity over the design’s lifecycle
  • Recommended architectural drawing and high level development plan

QHR consultants and the architect were on site for a four day rapid design event. To start, QHR consultants spent time at the Cancer Center observing and interviewing the hospital’s Board, front-line staff and patients to understand the Cancer Center’s current performance. They analyzed processes to determine current patient treatment times. The Cancer Center’s existing space was also evaluated to determine how the design impacted workflow and patient experience. Finally, QHR analyzed the staffing needs and the efficiency of the Cancer Center’s support processes.

As part of the initiative, QHR helped ensure that Montrose involved the Oncologists and the entire staff in the design process, resulting in total buy-in of the new process from everyone involved. At the end of the four days, the team provided a series of architectural drawings that satisfied the goals of the leadership team and met varying capital constraints that the Board could approve.


The Lean-redesigned processes required less space for the Cancer Center renovation, resulting in a more affordable and efficient design. QHR’s Lean design approach saved the hospital $1 million over original estimates. In addition to this significant savings, the design also:

  • Enhanced staffing efficiency
  • Improved customer experience
  • Increased the hospital’s bottom line
  • Improved productivity
  • Improved patient throughput
  • Improved safety and quality
  • Achieved savings through supply optimization
  • Improved staff communication and workflow
  • Increased patient satisfaction in part by reducing patient times nearly one hour