High Tech Creates Patient Inconvenience

A few weeks ago I had the misfortune of walking on a sidewalk and having a car jump the curb and hit me from behind. Fortunately, it was in a parking lot and the car was not traveling very fast and it was a knock down rather than a flight!

My wife drove me to a 24 hour free standing emergency room (affiliated with a local hospital – important later), the cost of the ambulance was vey high and I was not hurt that badly. The experience there was fine, seen timely, X-rays, staff handled paperwork and my personal needs very well. I am critical of these types of things, as you will see in other posts. Nothing broken so discharged home to rest.

Experience in an Emergency Department and Hospital Admission

The next series of posts will relate to recent experiences I have had while being a patient or involving personal experiences with family members as patients. The goal is to share ideas from the VOC – voice of the customer – perspective and encourage all to consider these as well as your own experiences. This is a “research” project on understanding the customer experience.

Recently, the EMS team was called to my home to take a family member to the Emergency Department of the closest hospital to our home. We had a very nice experience in the ED, staff worked well, kept us informed as to what was going on and what would happen while there. It was determined that an inpatient admission was in order. We were told that a “hospitalist” would see us either in the ED or shortly after arriving on the floor.

Voice of the Customer

The next five posts will highlight the five principles mentioned in the first post.

As mentioned in our introductory post, the VOC is critical to the success of any business but also to the development of and implementation of Lean Management in your medical practice. Just exactly is your customer looking for when they come to your medical practice? They have a list of questions, symptoms or needs. The individual visit is addressed at triage and with the direct encounter with the provider. The patient leaves with a plan and is “happy”!

But why did they choose you in the first place? Did you really meet their expectations during that visit? These are critical questions to find answers. So you now do a patient satisfaction survey and you find out that they don’t like to wait? Can you find out more?

Basics of Lean

Lean Management has been made “famous” by Toyota Motor Company and its “Toyota Production System”, TPS. Authors James Womack and Daniel Jones authored the first major publication, “Lean Thinking” in which they highlighted five principles:

• Value desired by the customer (VOC) 
• Value stream for each product/service 
• Product (service) flow continuously 
• “Pull” between steps 
• Manage toward perfection 

We will highlight each of these in many ways throughout the history of this blog.

One of the cornerstones not listed as a principle but certainly key the success of your efforts to become more efficient is to eliminate “muda” or waste! It has long been known, and no one will really argue that we waste time each day. How much time do you and each of your employees waste in a normal day? It is estimated that this will amount to 25% of your day, that’s two hours, that’s 120 minutes! Can you find ways to eliminate 10% of that muda, or 12 minutes? If everyone in the office was more effective for 12 minutes each day, let’s say there are five people in the office that means we have improved productivity by one full hour!

Introduction to This Blog

We all can agree that the world of the medical practice is changing rapidly. The moves to value based payment models, emphasis on quality, patient satisfaction, payment mechanism changes, evidence based medicine, and so much more are creating the need for today’s practice manager and the team to revise its focus. We no longer can do things “the way they have always been done!”

Here is where this blog will come into play. The goal is simple to share ideas and practical solutions with readers on what has been tried and worked or in some cases did not work in achieving the ultimate goal of every medical practice – meet patient expectations by providing the highest quality of care possible.

Peter Drucker said it best when he noted that for a business (the medical practice is a business!) to be successful you must first serve the customer, profits and financial success will follow. The principles behind the management theories of Lean and Six Sigma highlight the “Voice of the Customer”, VOC, as their cornerstone. Focus on meeting the customer needs on everything that is done, every task accomplished in the most efficient way and time, will lead to improved service to the customer.

In this blog, we will look at the principles of Lean Management and Sigma Magma. This may have already turned off some readers! Since these principles started in the manufacturing arena, they cannot nor do they apply to the medical practice. Please read on, I hope to convince you of just the opposite.

Let’s assume the patient has made the phone call and is now at the office prior to their appointment time. They will be checked in, move through triage, visit with the provider, immediate follow up activity as directed by the provider, and check out. This is basically a five-step cycle. If you think it through, each step is sequential and resembles an assembly line!

The first few posts will provide more detail and background on the principles of Lean and Six Sigma. Included will be some practical suggestions on applying those principles. It is hoped that readers will gain benefit from many of these posts and apply the concepts discussed in ways appropriate for their practices. Overtime, it is hoped that readers will share with the author their stories, which will be converted to more practical suggestions for others to attempt.

Remember the ultimate goal is to meet the VOC in a way that is satisfying and at the same time improves their individual health status.

photo credit: via photopin cc