Jayasinha Yasangi
Department of Pediatrics, UCLA David Geffen School of Medicine, Olive View-UCLA Medical Center, Sylmar, California.
Qual Manag Health Care. 2016 Jan-Mar;25(1):38-43. doi: 10.1097/QMH.0000000000000083.
Increasingly, health care quality indicators are focusing on patient-centeredness as an indicator of performance. The National Quality Forum lists assessment of patient experience, often conducted using patient surveys, as a top priority. We developed a patient-reported time stamp data collection tool that was used to collect cycle times in a safety net hospital-based outpatient pediatrics clinic.
Data were collected using patient-reported survey to obtain cycle times in Pediatric clinic, as well as qualitative and quantitative patient satisfaction data. Several rapid-cycle improvements were performed using Lean Six Sigma methodologies to reduce cycle time by eliminating waste and revise unnecessary processes to improve operational effectiveness and patient and staff satisfaction.
A total of 94 surveys were collected and revealed average cycle time of 113 minutes. Our measured patient satisfaction rating was 87%. Discharge and check-in processes were identified as the least efficient and were targeted for intervention. Following implementation, the overall cycle time was decreased from 113 to 90 minutes. Patient satisfaction ratings increased from 87% to 95%.
We demonstrate that using Lean Six Sigma tools can be invaluable to clinical restructuring and redesign and results in measurable, improved outcomes in care delivery.
医疗保健质量指标越来越注重以患者为中心作为绩效指标。国家质量论坛将患者体验评估(通常通过患者调查进行)列为首要任务。我们开发了一种患者报告的时间戳数据收集工具,用于收集一家安全网医院门诊儿科诊所的周期时间。
通过患者报告的调查收集数据,以获取儿科诊所的周期时间以及定性和定量的患者满意度数据。采用精益六西格玛方法进行了几次快速循环改进,通过消除浪费来减少周期时间,并修订不必要的流程以提高运营效率以及患者和员工满意度。
共收集了94份调查问卷,显示平均周期时间为113分钟。我们测得的患者满意度评分为87%。出院和登记流程被确定为效率最低的环节,并成为干预目标。实施后,总体周期时间从113分钟降至90分钟。患者满意度评分从87%提高到95%。
我们证明,使用精益六西格玛工具对临床重组和重新设计非常宝贵,并能在护理提供方面带来可衡量的、改善的结果。