Humanizing Perioperative Care Through Lean Thinking and Value-Based Healthcare: A Nurse-Led Organizational Redesign

Abstract

Introduction. Perioperative pathways are often experienced as fragmented and impersonal; humanizing care requires organizational redesign, not merely better communication. Lean Thinking and Value-Based Healthcare were adopted to improve accessibility, continuity, and patient-centered value in a public hospital surgical pathway.

Methods. A nurse-led quality improvement project used service blueprinting, patient-reported experience measures, and AI-assisted semantic and sentiment analysis of complaints submitted to the hospital Public Relations Office. Interventions included a surgical Welcome Unit, a modular perioperative information kit, standardized admission and discharge checklists, frailty screening with the Tilburg Frailty Indicator, anxiety/information needs assessment with APAIS; “What matters to me?”, Community Care Coordination Centre involvement; and post-discharge nursing follow-up with QoR-15.

Results. The initiative established a structured framework for humanizing the perioperative pathway by standardizing key touchpoints across pre-hospitalization, admission, and discharge. It integrated formal assessment tools, personalized information, continuity mechanisms, and follow-up strategies. The A3 report and Gantt chart supported prioritization, phased implementation, and monitoring through experience, complaints, and recovery indicators.

Discussion. Humanizing perioperative care requires both relational and organizational change. Lean Thinking and Value-Based Healthcare helped redesign the pathway around patient priorities, frailty, and continuity, showing how nurse-led innovation can translate humanization into structured perioperative practice.