At Fik Hospital, in the Somali Region of Ethiopia, the Central Triage Department serves as the critical gateway for all patients seeking care. For Dr. Abdi Muktar, leading this unit meant balancing urgency, precision, and overwhelming patient volume. Managing the constant stream, from those with minor ailments to patients in acute distress, required not just medical expertise, but an impeccably organized system.
For too long, the system itself was part of the problem. Crowded waiting areas, unclear pathways, and inconsistent procedures created bottlenecks that delayed care from the very first moment a patient arrived. During peak hours, the pressure escalated, increasing the risk of errors and stressing both staff and patients, particularly women, girls, and other vulnerable groups, seeking essential services.
“The pressure was high, and delays were common,” Dr. Abdi recalls. “We needed a smarter way to channel the flow of people and prioritize needs.”
Transforming lifesaving care through Kaizen
The opportunity to address these challenges came through Kaizen training, a Japanese management philosophy for continuous quality improvement. In March 2025, UNFPA, with funding from the Government of Japan, launched a humanitarian response project to enhance the health, well-being, and protection of women and girls in emergency-affected communities of the Somali Region.
In partnership with the Somali Regional Health Bureau, 27 health providers, including Dr. Abdi, completed 5S-KAIZEN-TQM training in Jigjiga, capital of the Somali Region. The methodology equips staff to identify inefficiencies, streamline processes, and engage teams in continuous improvement – a vital tool in contexts where timely, safe care can be lifesaving. The training’s principles – eliminating waste, standardizing procedures, and involving every team member in problem-solving – provided a clear framework to reorganize the patient journey from arrival to assessment.
The triage team mapped each step, redesigned physical spaces into distinct zones for registration, assessment, and waiting, standardized procedures, and formalized coordination among nurses, clerks, and clinicians. These changes turned a collection of individual roles into a synchronized, accountable team, improving both workflow and morale.
Safety, efficiency, and trust
The effects were immediate and tangible. Patients, including pregnant women, adolescent girls, and other vulnerable groups, were assessed faster and directed to the appropriate services without confusion. Waiting areas became calm and orderly, reducing the risk of deterioration before care and enhancing patient safety.
Staff experienced a profound cultural shift. With clear roles, standardized processes, and a shared commitment to continuous improvement, morale and accountability soared. Confidence in their work radiated outward, improving the patient experience from the very first interaction.
“Patients feel the difference,” Dr. Abdi confirms. “They arrive anxious and leave reassured, knowing they will receive prompt, safe care.”
By applying Kaizen principles, Fik Hospital’s Central Triage Department has re-engineered the first chapter of a patient’s care journey. Critical interventions, including sexual and reproductive health services, now begin sooner, building trust and respect from the first point of contact. The ripple effects strengthen every department that follows, proving that investing in people and processes is one of the most powerful ways to deliver patient-centered, safe, and efficient healthcare, particularly for women and girls in humanitarian settings.
