An Improvement of Patient's Experiences in Kemang Medical Care

Abstract

Introduction – Various attempts have been made by the hospitals to provide more positive performances. An effort to improve the quality of hospital that has been proved nowadays is Lean Six Sigma (LSS). A bunch of positive cases about the successful application of LSS at hospitals raises the concept of lean healthcare. In the model of LSS, Lean contributes as the implementation stage, while Six Sigma acts as systematization step.Methodology – KMC apply LSS by forming LSS team consisting of one black belt, two sponsors, and three members. The team create project plans with PDSA method at three levels: Top, Middle, and Low. After PDSA is composed, we operationalize it by using DMAIC. In the DMAIC procedure, we apply the Lean methods, such as designing the Value Stream Mapping (Define), determining Future State (Measure), sustaining (Kaizen), and communicating the result (Visual Board). To determine the performance of LSS, we define five dimensions of measurements that include quality, inventory, time, productivity, and costs.Results – Overall, the implementation of LSS in the KMC was successful in the context of Patients’ Experiences. In terms of patient safety, we managed to reduce medication error from 15 to 8 and reduce the types of errors from two types (wrong documentation and time misunderstanding) to one type (wrong documentation). In terms of speed, we managed to reduce the waiting time at all stages. Registration time dropped from 12 minutes to 3 minutes. Time waiting in the doctor's office dropped from 38 minutes to 24 minutes. Waiting time in taking the drug dropped from 26 minutes to 13 minutes, and the waiting time in payment down from 7 minutes to 3 minutes. In terms of satisfaction, we decreased numbers of complaints of patients from 22 to only 4 complaints.Discussion – LSS implementation at KMC gives a positive effect and strengthens the results of previous studies related to the effectiveness of LSS in health service. We also find out that performances of LSS varies, depends on the clinic’s characteristics. Therefore, some indicators can be more quickly achieved in one clinic than in other clinics. We strongly recommend that this method of quality improvement is also applied elsewhere to improve service to patients.