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The Key to Success Is Small,
IncrementalImprovement
Wafa Al-AhmedBsc, PgD, MLS(ASCP)CM
Senior Quality Assurance Officer
Improvement of AMC Customer Services in Reception &
Phlebotomy Room
3
1ST VALUE: PATIENT WAIT TIME
Definition Wait time from the patients’ arrival to the laboratory reception area and the time at which the blood collected.
Problem Patient waiting time in the reception area seem to be higher
between 10:30 AM – 12:00 PM. Consequences -Excessive time spent away from work or personal activities. -Patients might leave and seek care elsewhere.
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2ND VALUE: CUSTOMER SERVICE
Effective Communication Skills with Patients
- Verbal Communication: face-to-face, or telephone- Non-Verbal Communication: body language, gestures,
how we dress, act or our scent.
Maintenance for Reception Area & Phlebotomy Rooms- Walls & Doors Paintings- Lining Chairs - New Storage Cabinets- Rest Rooms Hygiene
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VALUE STREAM MAPPINGPHLEBOTOMY WORK FLOW FOR
OUT-PATIENTS
Enter
Patie
nt Data in LIs
Payment
Phlebotomy
Payment Type
CASH
Get Approval from Insurance Dept
Insurance
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MINIMIZE WASTEPHLEBOTOMY WORK FLOW FOR OUT
PATIENTS
Enter Patient Data in
LIs
Payment
Phlebotomy
Payment Type
Get Approval from
Insurance Dept
CASH
Insurance
WaitTime
WaitTime
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FACTS & DATA COLLECTIONDATE 17/8/2015, TIME 10:30 AM-1:50 PM
NOTE: CHILDREN WERE EXCLUDED
Patient No.
Time In Time Out Wait Time (min) PaymentCash/ Insurance
1 10:30 10:50 20 Insurance2 11:00 11:20 20 Insurance3 11:00 11:15 15 Cash 4 11:05 11:20 15 Cash5 11:10 11:32 22 Insurance6 11:15 11:53 38 Insurance7 11:30 11:55 25 Insurance8 11:30 12:00 30 Insurance9 11:40 12:05 25 Insurance
10 12:10 12:25 15 Cash11 12:12 12:35 23 Insurance12 12:40 12:50 10 Cash13 12:45 12:53 8 Cash14 12:50 01:00 10 Cash15 12:50 01:13 23 Insurance16 12:55 01:20 25 Insurance17 01:10 01:23 13 Cash18 01:15 01:35 20 Insurance19 01:15 01:37 22 Insurance20 01:17 01:50 33 Insurance
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CREATE FLOWTAKT TIME PER 24 HOURS
ON 17TH AUGUST, 2015Takt Time Calculator
Working Shifts per
Day 3 Shifts
Hours per Shift 8 Hours
Break Time per
Shift 5 Minutes
Lunch Time per
Shift 30 Minutes
Planned Downtime
per Shift 10 Minutes
Customer Demand
per Day 135 Units
Available Time per
Shift 480 Minutes
Net Working Time
per Shift 435 Minutes
Net Working Time
per Shift 26,100 Seconds
Net Available Time
per Day 78,300 Seconds
Takt Time = 580 Seconds per Piece
Takt Time = 9.7 Minutes per Piece
88
Definition
Takt time is the time required to deliver quality services (to produce customer requirements)
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ESTABLISH PULL
Minimize Waste1. Insurance Approval by Accountant in Lab Reception Area2. Two Technologists for Serving the Customers
3. Two Technologists for Phlebotomy during Rush Hours
Lean Thinking & Effective Communication Training & Workshops
PERFECTION 5TH LEAN PRINCIPLES
Problem Solving
By Root Cause Analysis
People & Partners(Respect, Challenge, Teamwork & Grown them Process
(Eliminate Waste)Right process will deliver right product
Philosophy (Long-Term Thinking) (Continuous Improvement & Learning)
PLAN, DO, CHECK, ADJUST (PDCA) CYCLE
• Presentation for: Lean Thinking & Effective Communication
• Training based on Simulation & Role Play
• Insurance Approval by Accountant in Lab Reception Area
• Two Technologists for Serving the Customers
• Study Cases
• Calculate Tact Time/patient for Phlebotomy Service
• Lab Director Assign Phlebotomy Senior• Quality & Safety Calendar• Quality Rounds
• Plan Educational program based on Communication Skills
• Collect Data for Patients’ Waiting Time for Two Weeks
• Calculate Tact Time• Fix Phlebotomy Rooms Wall Paintings & Chairs Lining•Conduct Quality Rounds•Develop Continuous Quality• Improvement Policy
• The change was a measurable success• Standardized Patient Waiting to be 10
min/patient
Act Plan
DoCheck
12
REFERENCES
Improvement, N. H. S. Bringing lean to life. Leicester, UK: NHS Improvement. 2010.
https://leansixsigmahealthcare.wordpress.com/2015/06/24/using-lean-six-sigma-analytics-to-improve-patient-wait-times/
http://www.6ixconsulting.co.uk/IGLC-Application-of-Batch-size-reduction-in-construction.pdf
