Lean into the Challenge: Improvements Made in Physician Practices

Updated on November 11, 2014

For many physicians, it can be difficult to envision how to change their current practice into a more productive, efficient and gratifying operation.  Practices are pushed to their limits, resulting in long patient wait times, overworked and frustrated staff, and physicians who are trying to balance patient needs with staying on schedule.  Plus, many practices are now part of a larger healthcare system with corporate goals, new technology implementations and pressures to reduce costs and generate even more revenue.

The answer, for many providers, is taking a Lean approach within their practice.  For three physician practice Offices in a large healthcare system in the Midwest, they transformed their daily processes by:

  • removing redundancy
  • streamlining their workflow
  • focusing on improving the patient experience

By using Lean concepts, these Southern Ohio-based clinics were able to improve their operations, gain leverage in the marketplace and raise the quality of care within their community.

Closer to C.A.R.E.® with Lean Solutions

These three clinics partnered with TechSolve to improve the overall experience for their patients, while boosting staff morale and increasing their capacity to serve more patients.

The three clinics worked on these service areas:

  • Clinical diagnostics and treatment
  • Lab testing
  • Urgent care
  • Evaluation
  • Non-invasive diagnostic testing
  • Treatment for heart-specific conditions
  • Care coordination follow up

From the beginning, the three clinics were faced with many similar issues that commonly occur in physician practices.  Unfortunately, the care delivery processes often receive very little attention because resource time is not adequately invested in improvement opportunities.  Everyone is extremely busy, and as a result, they enter a cycle where team members become frustrated with process inefficiencies, which can easily translate into patient dissatisfaction.

Common Challenges in Physician Practices

  • Large, overcrowded waiting rooms
  • Long patient wait times
  • An inability to schedule patients within a short period of time
  • Decreased staff morale
  • Low patient satisfaction
  • Lack of organized supplies and equipment
  • Inability to handle phone call volume
  • Ineffective communication leading to duplication of efforts
  • Insufficient information to complete tasks
  • Increasing competition within the marketplace

Whether practices are part of a larger healthcare network or remain independent, the need to address issues is critical given the competitive and complex nature of today’s healthcare marketplace.

Engaging Staff in Lean

All three clinics formed teams engaging frontline employees and physicians to implement the Lean methodology within their own practices.  Each clinic delivered care in a slightly different way, yet used the same, structured approach to implement customized solutions that overcame shared obstacles.

  • Through a series of observations, they discovered that duplicate documentation existed throughout the chart.  By mapping the current patient experience, it became apparent that the majority of the patient’s time was spent in non-value added activity, such as waiting to see a care provider or repeating their chief complaint more than once.
  • The rapid improvement experiments that each team performed had positive impacts on both internal and external customers.  From the nurse and physician perspective, they could provide better quality care by hearing what each other said to the patient.  The patient office clerk felt a sense of pride and satisfaction, being connected to the care process in a direct way, instead of at a distant desk.
  • The Lean process had a clear impact on the patient experience.  Patient comments were extremely positive.  They noticed the new efficiency and were vocal about the positive change.  Problem areas, like the waiting rooms, as a result of the process change, experienced improved patient flow. The staff could predict the rhythm necessary to make critical decisions. The waiting rooms were no longer overcrowded, as empty chairs often filled the space.
  • The overall impact in each medical office has taken effect across the entire organization. 

The overall impact of using Lean for process improvements was experienced at all of the three clinics, resulting in an increase in capacity to see more patients per day, improvements in patient flow and an increase in patient and staff satisfaction.  Moving away from a disjointed system, the staff was better able to care for and educate the patient through the coordinated delivery of care.  Physicians were able to complete documentation before the end of the day, an experience several had not had a long time. Patients no longer had extensive wait times and were able to tell their story to the team at one time. Plus, from the network’s perspective, costs had been reduced, while increasing revenues generated by seeing additional patients.  In addition to achieving an estimated $423,892.00 in hard dollar savings, the organization benefited from patient loyalty, improving their image within the community.

Physician practices are playing a critical role in the changing healthcare landscape.  It is pertinent that large healthcare networks and independent groups alike make moves toward patient-centered models and increased revenue opportunities to remain competitive and in a position to deliver top notch care.  Lean process improvement is a unique approach because it empowers those closest to the work to improve it continuously – not in just one big project.  Small, incremental, and consistent improvement through teamwork will drive better quality, while simultaneously removing unnecessary, and often costly, activity.

For more information on TechSolve, please visit www.techsolve.org.

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