Use of lean sigma principles in a tertiary care otolaryngology clinic to improve efficiency

Sandra Y Lin, Dean Gavney, Stacey L. Ishman, Julie Cady-Reh

Research output: Contribution to journalArticle

Abstract

Objectives/Hypothesis To apply Lean Sigma, a quality-improvement strategy supported by tactical tools to eliminate waste and reduce variation, to improve efficiency of patient flow in a large tertiary otolaryngology clinic. The project goals were to decrease overall lead time from patient arrival to start of interaction with care provider, improve on-time starts of patient visits, and decrease excess staff/patient motion. Study Design Prospective observational study. Methods Patient flow was mapped through the clinic, including preregistration processes. A time-stamp observation study was performed on 188 patient visits over 5 days. Using Lean Sigma principles, time stamps were analyzed to identify patient flow constraints and areas for potential interventions. Interventions were evaluated and adjusted based on feedback from shareholders: removal of bottlenecks in clinic flow, elimination of non-value added registration staff tasks, and alignment of staff hours to accommodate times of high patient census. A postintervention time observation study of 141 patients was performed 5 months later. Results Patient lead time from clinic arrival to exam start time decreased by 12.2% on average (P =.042). On-time starts for patient exams improved by 34% (χ2 = 16.091, P

Original languageEnglish (US)
Pages (from-to)2643-2648
Number of pages6
JournalLaryngoscope
Volume123
Issue number11
DOIs
StatePublished - Nov 2013

Fingerprint

Otolaryngology
Tertiary Healthcare
Observation
Censuses
Quality Improvement
Observational Studies
Prospective Studies

Keywords

  • ambulatory flow
  • clinic efficiency
  • clinic performance
  • Lean
  • outpatient clinic
  • patient flow
  • Six Sigma

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Use of lean sigma principles in a tertiary care otolaryngology clinic to improve efficiency. / Lin, Sandra Y; Gavney, Dean; Ishman, Stacey L.; Cady-Reh, Julie.

In: Laryngoscope, Vol. 123, No. 11, 11.2013, p. 2643-2648.

Research output: Contribution to journalArticle

Lin, Sandra Y ; Gavney, Dean ; Ishman, Stacey L. ; Cady-Reh, Julie. / Use of lean sigma principles in a tertiary care otolaryngology clinic to improve efficiency. In: Laryngoscope. 2013 ; Vol. 123, No. 11. pp. 2643-2648.
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