Integrating Lean Methodologies and Simulation Modeling to Accelerate Patient Flow and Reduce Waiting Times: A Desk Analysis

The effectiveness and calibration of the healthcare system worldwide are still threatened by lengthy wait times for patients. The purpose of this systematic review is to critically assess how Discrete Event Simulation (DES) and Lean Methodologies (LM) can reduce patient wait times in various healthcare settings. Using the PRISMA guidelines, 35 peer-reviewed articles from four major databases, published between 2015 and 2025, were carefully selected. Data was extracted to identify applied tools, study contexts, and validated outcomes. The findings demonstrate that, particularly in outpatient and emergency settings, a stand-alone Lean tool enhances patient flow and reduces delays. However, by enabling real-time scenario testing and streamlining workflow modifications without interfering with operations, the integration of LM with DES provides additional advantages. The results also show a lack of long-term sustainability strategies in LM or DES projects and a research gap in low- and middle-income countries. In addition, cross-functional teamwork and leadership engagement were crucial success factors, whereas staff disengagement and a lack of real-time monitoring were major obstacles.In summary, the combined application of LM and DES offers a practical and cost-effective approach to addressing patient flow issues. To improve implementation outcomes, future research should prioritise stakeholder involvement, digital performance tracking, and sustainability.