Redesigning patient flow in orthopedics and radiology clinics via a three-phase 'Kaizen' improvement approach and interrupted time series analysis.

Abstract

The orthopedics clinic at an academic medical center has low patient satisfaction rates for patients that require an X-ray and have difficulty ambulating. The project aimed to reduce the 'non-value-added' time during appointments by using Lean and Six Sigma methodologies and enhance patient experience. An analysis of the current state was conducted using Gemba walks, interviews with subject matter experts and an interrupted time study to assess baseline data. The project was implemented using a three-phase Kaizen event approach. Interventions implemented included: (i) re-engineering patient flow and (ii) standardizing appointment scheduling guidelines. The 'non-value-added' appointment time was measured post-intervention and it decreased from 17 to 8 min (51%), and 87% (N = 47) of patients rated the scheduling process positively. Lean, Six Sigma and Kaizen improvement methodologies are invaluable tools to improve operational efficiency. The implemented interventions enhanced patient experience and improved clinic efficiency.