A Lean/Continuous Improvement (CI) culture in health care organizations leads to the achievement of strategic goals by means of a serious commitment to excellence in quality while developing and sustaining an integral patient centered care system.
Most strategic plans for health care institutions can be defined by three main pillars:
Improvement of Quality: engaging patients as partners to achieve excellence in health care services.
Maximization of Value Added services: so as to excel at providing health care to patients while being financially sustainable.
Build an Exceptional Team: in order to be able to achieve team synergy in the organizational efforts to provide unparalleled health care.
The implementation of a Lean/CI culture in health care institutions provides tangible results while addressing and focusing on the improvement of specific and well determined key performance indicators (KPIs) in order to enhance operational efficiency as for instance eliminating bottlenecks in a hospital workflow, both internally and within the sub-LHIN, so that cycle times can be reduced and provide more value to patients in a shorter period of time. A few examples of KPIs are listed below.
# Of Mistake Events: quantifies the mistakes made in the organization, which can be sorted by mistake category.
Patient Confidentiality: quantifies the number of times a patient’s confidential information has been compromised.
Patient Satisfactiont: determines satisfaction categories and how likely patients are willing to come back to use your services again.
Patient Wait Time: determines the average time a patient must wait in order to see a physician/health care provider.
Workflow/Cycle Time: This metric measures the time it takes to process an order (i.e. MRI, DI, etc.)
Staff/Patient Ratio: determines the staff capacity and helps with the re-allocation of resources.
Staff satisfaction rate: determines staff satisfaction and how likely employees are willing to stay and contribute with your organization to achieve the strategic plan.
Trainings/Department: quantifies the amount of training each department provides or receives.
Communication between external Physician & Staff: evaluates the process efficiency in order received by external practitioners and how they are handled within your organization.
The imaging department of a South Western Ontario hospital experienced long cycle times in their booking process. External physician booked appointments and the requisition generated a paper form that travelled within departments and hospital buildings in order to complete the booking process. Many delays were caused by forms being temporarily lost or by simply moving them from one place to another.
Moving to a paperless solution seemed to be the right decision while developing a software inter phasing between the hospital and the physicians booking the appointments. The difficulty was that each physician used their own software and this solution would have required the development of inter phases for each physician (financially unviable). Making use of a Lean/CI tool called Pareto rule (aka rule of the 20/80) the hospital determined that 80% of most influential delays were caused by only 20% of physicians. The hospital developed an inter phase platform to address this 20% of booking cases and achieved an overall cycle time reduction in the order of 62% and was able to relocate resources to other areas in need of more staff.