Exploring the use of the Lexis diagram for monitoring lead times in health care: the illustrative case of an outpatient referral process

Journal article, 2014

The ‘Lexis Diagram’ has traditionally been used in Demography and Epidemiology for graphical representation of event histories. Timeliness is often cited as the Achilles' heel of Swedish health care. This paper explores the use of the Lexis diagram for monitoring lead times and thus contributing to improved timeliness of healthcare processes. The study was exploratory in nature and followed a qualitative approach. For illustrative purposes, data on an outpatient referral process consisting of four milestones were used to produce a Lexis diagram. The Lexis diagram may complement the reporting of waiting times imposed by maximum waiting-time guarantees. It is expected to contribute to a more holistic view of processes and to a more precise measurement of lead times, enhance the ability of practitioners to react on time while the object is still active in the system and motivate improvements in staff scheduling by increasing the knowledge about the number of objects currently active in the system. However, it may contribute to an excessive emphasis being placed on time, which may distort clinical priorities. To the best of our knowledge, using the Lexis diagram for monitoring lead times represents a novel application of the diagram.