The authors adopted a Lean concept to improve patient wait times, delays, clinic inefficiencies and patient satisfaction. They report the outcomes of implementation in this paper. Visit time, and patient and staff movements during patient examinations were mapped. Patient examinations were simulated prior to implementation of a new patient flow system. The system used a visual real-time electronic board within the clinic to show patients flow at each stage, including time between steps. They collected patient satisfaction surveys in addition. Four years of data from 2018 were collected. Pre-implementation, mean clinic wait time was 120 minutes. Within three months of implementation, this reduced to 75 minutes (range 57–94). After four years, this was maintained at a mean of 69 minutes. Satisfaction surveys showed improvement from a mean of 6.5 to 9.0 (1 being low and 10 high). The process started with the patient being seen by the orthoptist. There was a change to templates for appointment types. The physician used two rooms instead of one and a standardised set of equipment was available in each room along with doorbells installed for when staff needed help.
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Lean concept implementation process to improve clinic efficiency
Reviewed by Fiona Rowe
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Fiona Rowe (Prof)
Institute of Population Health, University of Liverpool, UK.
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