Value Stream Mapping Helps Medical Center Improve Wait Times

Value Stream Mapping Helps Medical Center Improve Wait Times

By Discovery Lean Six Sigma

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Value Stream Mapping Helps Medical Center Improve Wait Times

The implementation of process improvement in healthcare is now beginning to have a direct impact on patient experience.

The issue, in this case, is time – time spent waiting and time spent undergoing routine screenings and scans.

A Philadelphia hospital took on the task of improving outpatient wait times. They experienced success, partly by using Value Stream Mapping to identify process issues.

Started by Toyota, Value Stream Mapping improves process improvement efforts by changing both overall corporate culture as well as individual behavior.

Hospital Challenges

The radiology department at Temple University Hospital implemented process improvements to combat what people viewed as a “cumbersome and inefficient” operation around scheduling and performing CT scans.

The department cut down the time spent by patients – both in waiting and in undergoing the scan itself – to just over an hour or about one-third of the previous wait time. They also increased the number of scans completed per day to 44. Formerly, they handled 37, according to the report published by the hospital in the Journal of the American College of Radiology.

The process of change first involved bringing in people from across the organization in addition to the radiology department: information technology, finance and outside consultants, to name a few.

The group then went through the Value Stream Mapping process, which proved to be the key step in making needed changes.

What Is Value Stream Mapping?

The basic definition of Value Stream Mapping is it serves as a tool for identifying wasted and unnecessary activities within a process. That includes both at the individual level and with across-the-board corporate culture and processes.

Those wasted activities, as defined in Lean Six Sigma, are: defects in the product, extra processing, inventory, non-utilized talent, over-production, transportation, waiting and wasted motion.

Using Value Stream Mapping allows for the creation of a diagram that makes these areas of waste become readily apparent.

It’s one of the most useful tools in process improvement. By mapping out processes, employees can identify the root causes of errors, defects and wasted activities. Eliminating those root causes can lead to a significant decrease in the chances they will happen again.

The most important, overarching requirement for a Value Stream Map is that it represents what actually is happening in a process. Value Stream Mapping represents the reality of a process. In another words, not the way a process should work, but how it is actually performing.

The details of creating a Value Stream Map can change depending on the approach. Some do an initial map by hand in pencil, because there will be plenty of erasing. Software also is available to help.

Whatever the approach, a Value Stream Map diagrams in great detail every step of a process, from beginning to end. The diagram should be created from the point of view of customers. The ultimate goal is to create a process that gives them the best product or service available, as well as making the process more efficient. No detail is too small. Everything must be considered.

Implementing Change

In the case of Temple University Hospital, every step of the process between a patient checking into the radiology department and checking out was mapped beforehand.

The multi-disciplinary team then took results from the Value Stream Mapping and created a prioritization matrix, which ranked potential changes based on their impact on process improvement as well as ease of implementation.

Some of the areas needing improvement included:

  • Poor communication within the radiology department
  • Redundant paperwork
  • Missing lab work
  • Ergonomics in the department
  • Inaccurate orders taken from patients on their arrival

To address these issues, the team created a weekly meeting to discuss changes to make improvements in these areas. Additionally, a “steering committee” was formed to meet monthly to make decisions on changes and oversee implementation.

As with most cases involving process improvement, small changes led to big results. Some of the changes included a review of a patient’s records three days before arrival of the patient to get up to date on their treatment and search for any errors.

Daily reports on defects in the process were given to managers for review. Renovations to the department enhanced ergonomics. Duplicative paperwork was eliminated. And the three-day in advance review helped better schedule patient visits and the use of equipment in the department.

The time for patients in the department, from first check-in to departure, fell from 3.1 hours to 1.1 hours.

In the report, Temple University Hospital noted that a thorough analysis on non-clinical factors such as those listed above helped to vastly improve patient experience and departmental efficiencies.

In the world of process improvement, those are the ultimate goals.

The post Value Stream Mapping Helps Medical Center Improve Wait Times appeared first on Six Sigma Daily.

By: James LoPresti
Posted: September 21, 2017, 5:50 pm

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