Lean in Hospital Primary Care

Lean Six Sigma Tools

Performance Measurement
5S Visual Management
Spaghetti Diagrams
Time Study

Details – Performance Measurement

1. The team first learned about Performance Measurement and then created their Performance Scorecards. 
2.  As you can see, On Time Delivery of service shows up twice as measures of seeing patients at their appointment times. (How may of you have waited for your doctor’s visit well past your appointment time?) These are also the measures that are doing the worst.

Details – 5S Visual Management

1. The improvement project began with the most important Lean tool, 5S Visual Management. The team felt that an important contributor to poor on-time-appointments was the time that Doctors and Nurses were spending looking for instruments, supplies (gloves), phone numbers and patient-educational pamphlets.
2. The rooms were 5S-ed, with the most important aspect being the standardization of supplies and patient information (pamphlets).
3. What you see in the picture is Primary Care hallway. It was cluttered with things on the floor (hard for patients to maneuver around) and too many bulletin boards (which had random information). It is now organized and patient-friendly.

Details – Spaghetti Diagrams & Time Study

1. In the linked slides you will see the Spaghetti Diagram we did of a Primary Care visit.
2. The diagram shows two areas for improvement. First, was the incredible number of in and out trips by the Provider and Nurse. Second, the wasted space in this room.
3. By also doing a time study, we can see additional areas of improvement including the time that the patient must sit in the room while the Provider completes the Encounter.
4. This analysis led to a complete rethinking on the layout of the Primary Care department to improve Patient Service and Nurse/Provider productivity.