Team Showcase:
2008 Team Showcase Competition: Region 4
| 2008 Region 4 Winner | ||
 |
||
Region Four |
Streamlining University Area Clinic Workflow
The University Area Community Health Center provides women’s services and pediatric services. The Workflow Team utilized a Lean Kaizen Process Improvement project in order to streamline operations and improve customer service. Customer satisfaction surveys frequently indicated dissatisfaction with the length of time spent by the patients during their appointments. Also, our providers complained about an inconsistent flow of patients to the exam rooms. Knowing the success Lean Kaizen had on organizations such as Toyota, where Lean began, it seemed natural to use this process to improve patient flow. Translated, Lean Kaizen means continuous improvement.
In order to ensure representation from all steps in the process, the team was formed with members from administrative support and clinical services. The Lean Kaizen began by following patients for both types of services through their entire visit and interviews with patients and providers. The team used Spaghetti Maps, Process Flow Maps, Time Analysis Graphs, and feedback from the patients and providers. Analysis of the data showed that there was a lot of wasted movement and long periods of wait time, both of which are non-value added activities. The team studied this information, taking note of things along the way that they felt were slowing down the process. The team then met and brainstormed to identify things they felt could be done to reduce the non-value added activities, which were then prioritized into most effective and could be done immediately. An action plan was developed and the team members went to work implementing these changes. All the while the team members kept other staff informed of what was happening and sought feedback from them as to what was working and what was not. Based on this feedback, those that were not working as well as they could be were adjusted. Significant changes that were made included performing all activities (except lab work) in the exam rooms. This includes taking histories, patient education, exams, immunizations and treatments. Also, a flagging system was implemented which gave visual awareness to staff as to what the next step in the process is for the patients in the exam rooms. A sub-waiting area was created to allow a nearby waiting area for patients who need labs, etc. in order to ensure they were not “lost” in the system.
The baseline information for pediatric visits indicated the total cycle time (entire visit from walking in the door to walking out the door) was 93 minutes of which 70% (65 minutes) was spent waiting for a value-added service to happen (i.e., lab work, exam, immunizations, etc.). After the Lean Kaizen process the cycle time was reduced to 75 minutes with 48% (36 minutes) being non-value added (wait and excessive walking) time. This meant a 22% reduction in non-value added time. The steps walked for the pediatric process alone were reduced by 70 feet just by eliminating movement to a separate area for immunizations. The baseline information for women’s service visits indicated the total cycle time was 84 minutes, of which 57% (48 minutes) was non-value added time. After the Lean Kaizen process the cycle time was reduced to 64 minutes with 39% (25 minutes) being non-value added time. This meant an 18% reduction in non-value added time.
Following a “one year check up”, it was found that under our new
and improved system, our customers and our providers are much more satisfied. The
University Area Community Health Center has had a 10% increase in the number
of patient visits. Because the clinic operates more efficiently now,
we can make more appointments and take more patients on a walk-in basis. The
significance of this is we are able to relieve stress on our community partners
such as the emergency rooms because we can see more patients and provide them
with appropriate care in order to prevent unnecessary ER visits. Valuable
lessons learned by the team included; focus needs to be on value-added activities,
unnecessary movement equals wasted time (patient and staff) and those who actually
do he work have the best ideas on how to improve the processes.
Counties in Region 4: Citrus, Hernando, Hillsborough, Pasco, Pinellas, Manatee, Sarasota