Article Revised: March 28, 2019
Modern health care presents numerous challenges to health care providers. Among them, patients want greater access to their providers. But the system is beset by scarce resources. There is limited time and availability for clinicians to care for patients. Holyoke Medical Clinic in Holyoke, Colorado, found a way to use Lean Six Sigma to improve patient satisfaction while also boosting staff productivity.
Like many growing health care facilities, Holyoke Medical Clinic at times found itself booked with many patients. That’s not a bad problem to have, particularly for a practice that wants to grow. But to manage that growth without adding staff, the clinic turned to a statistical methodology that documents changes made and shows the results that arose from those changes, according to an article in The Holyoke Enterprise. Using these concepts of Lean Six Sigma, a team found that the clinic’s customers – the patients – saw value in maximizing face time with their health care provider, receiving timely diagnostic test results, and being presented with a correct and understandable bill. That value was destroyed by long wait times, no call backs, no test results, no prescription refills, and rude treatment.
An underlying problem related to all of those pain points was staffing. The clinic had previously scheduled providers to see 13 patients per day. Factoring in no-show patients, the average worked out to 9.5 patients per day. Late-arriving patients delayed the entire schedule. Wait times were greatest in the walk-in clinic, which sometimes saw patients arriving in large groups, resulting in busy periods where not all patients could be seen.
Having identified those scheduling problems, the staff restructured processes to ask patients with appointments to arrive 15 minutes early to check in. With greater flexibility in scheduling, wait time in the lobby were reduced to approximately 15 minutes. With the walk-in clinic, Holyoke now operates on a structured schedule rather than on a first-come, first-served basis. The structured schedule reduced wait times, while still allowing the clinic to see up to 20 walk-in patients per day. Health care providers are working on other clinic duties beyond seeing patients. Those duties include wound-care clinics, nursing home visits, diabetes education, participation in surgery, and walk-in clinics.
In addition to better allocation of clinic resources for existing patients, Holyoke Medical Clinic is now planning ahead in order to manage a provider’s patient load. Scheduling is done 60 days in advance, instead of just weeks or even days ahead. Hospital administrator John Ayoub says that in time, the clinic hopes to have the clinic hopes to have scheduling in place 90 days in advance, even up to 120 days in advance with some providers.
Providers are also trying to make the patient visits as productive as possible, but only as long as necessary. Patient visits had previously been a standard 30 minutes. Now, providers are discussing with front office staff the appropriate length of time for each patient visit. And front office staff asks more questions of the patient when scheduling appointments to better gauge the amount of time needed for the patient’s visit. Improving a health care practice’s productivity does not have to mean adding more staff.