Six Sigma Lean Methodologies to Improve Efficiency and Reduce Patient Time in Clinic in an Occupational Health Clinic

Abstract

Cost effective, quality, error-free medical care is essential to positive health outcomes. The healthcare system has historically had difficulty with application of quality improvement processes because of the complex processes and systems and the transactional nature of the business. To Err is Human shed light on the disparities in health care delivery and quality of care issues (Institute of Medicine, 1999). In addition, the Affordable Care Act in 2010 has challenged the healthcare system to provide quality care in an efficient manner and reduce waste to gain the most financial benefit (US Department of Health and Human Services, 2012). Like other facets of healthcare, the occupational health clinic is attempting to provide quality, cost effective care in an attempt to minimize lost productivity and save money for the company. One way the healthcare system has responded is by the application of Lean Six Sigma principles borrowed from the manufacturing world. Lean Six Sigma provides a structured method of approaching quality improvement along with tools for sustainability by focusing on waste reduction and reduction of process variation (Koning, 2009). This project utilized the Six Sigma quality improvement process to create baseline metrics of existing processes within the occupational health clinic, collect real-time operational data and analyze ways to improve efficiency and decrease patient time in clinic. Through this process, it was determined that the greatest impact on patient time in clinic resulted from three primary variables: Issues with clinic flow, lack of appropriate standing orders for the nursing staff and inefficiencies with the scheduling process in the clinic. Through control of these variables, the clinic was able to identify process improvements to improve efficiency and quality and reduce costs.