Goal: Practice uses an organized approach (e.g. lean, process mapping) to reviewing its processes, eliminating or reducing waste in the process, and understanding the value of each process step to the patient and other customers.

Strategies

• Train staff in lean approaches and the concept of value
• Consider hiring or training internal experts in process improvement
• Use lean principles across the organization, such a defining waste and identifying value through the patient’s eyes
• Use process mapping to document workflows and identify value-add and non-value steps
• Convene regularly to discuss and improve workflows to optimize use of the EHR
• Use just in time inventory approaches
• Standardize exam room set up and supplies
• Optimize staffing on a daily basis to assure minimal down time of staff and space
• Centralized stock formulaic ordering with multisite facilities
• Establish pull production principles
• Put supplies in kits when frequently needed together
• Use spaghetti diagrams to track movement through the practice
• Cross train staff
• Standardize workflow across care teams and site where possible
• Integrate behavioral health
• Reduce exam room interruptions
• Use technology where possible to reduce effort required by staff
• Use standardized approaches for scheduling
• Translate productivity statistics to lost revenue to make the case to staff
• Use protocols for non-licensed staff
• Expand number of support staff per provider; evaluate the model regularly
• Optimize number of exam rooms per provider
• Use productivity measures that include non-visit related care
• Incent effective team-based care
• Eliminate phones from exam rooms; knock if needed
• Define use case for exam rooms (e.g. nurse visit)
• Optimize exam room workflow
• Use pagers for all staff to eliminate exam room interruptions
• Create a compensation model that does not create barriers to change
• Move from relative value unit-based compensation to relative value units plus performance metrics
• Develop a walk-in care model
• Adjust schedules to account for no show

Resources

Site: Quality Improvement Essentials Toolkit

Site: Six Sigma-definitions-history-overview

Site: Quality Management, history, gurus, TQM, process improvement, etc

Site: What is 5s