Using Lean concept in DM clinic Thailand

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Using Lean concept to increase efficiency in DM clinic service
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Using Lean concept in DM clinic Thailand

  1. 1. efficiency in Diabetic clinic service, Public Health Center 67 Taweewatthana Suthee Saritsiri, MD Director of Public Health Center 67
  2. 2. • Public Health Center 67 was established in 2007. • DM clinic opened service in 2008. Background - 6,445 *100 8,843 *122 12,339 *172 15,221 *214 20,600 *295 Patients * Registered DM patients 2008 2009 2010 2011 2012
  3. 3. By 1. Providing accurate, fast, through, and fair (good Governance) service 2. Development benefits to the organization and society. 3. Monitoring and evaluation of customer satisfaction. 12 years Development Plan Bangkok Metropolitan Administration’s Policy 5th Strategy: Develop a model management system of sustainable metropolis
  4. 4. LEAN concept Be better
  5. 5. Using LEAN concept to increase efficiency service . DM Pati ents Visit monthly NPO for DTX Unsati sfied emotio n Well glycemic control Healthcare providers may not be tired. Loss F/U Increased risk of complicati ons morbidity mortality Win – Win: Between patient and
  6. 6. Research question Can LEAN concept increase efficiency in DM clinic service?
  7. 7. Metodology of the study 1. Pre LEAN February 2012 2. Root Cause Analysis 3. Using LEAN Concept 4. Evaluate comparison Pre LEAN and Post LEAN External Customer needSWOT Analysis
  8. 8. 1.Time and Length in each steps of services (start to the end)(value+nonvalue but necessary+waste) Outcome evaluation Quantitative Qualitative 1.Physical environment: No. of service points 2. Human Resources: No. of Healthcare providers 3. Process: No. of steps in 1.Efficiency of service % = value Time x 100 Total Time 2. Satisfaction: DM patients and Healthcare providers
  9. 9. Implement LEAN concept 1. Physical environment
  10. 10. Door Nursing room 2 Medical record roomPhar macy Finan ce room Exa m room . Exa m room.counsel ing room Health educat ion room prepari ng Cue cards Elevat or Waiting Poi nt Service Cue cards Medical records room preparing Nursing room Examinatio n room Counseling Pre Lean
  11. 11. Door Nursing room Medical records room Phar macy room Finan ce room Exa m roomExa m room 2 counse ling room Health educati on prepa ring Cue cards 1 Elevat or Waiting 7 8 Floor 1 Post Lean
  12. 12. Blo od exa m couns eling room X-ray room 3 5 Eleva tor Waiti ng preparing 4 2 6 Scree n Floor 2 Poi nt Service 1 Cue cards 2 Screen BW BP 3 Blood 4 Preparing 5 Exam room 6 Counselin g room 7 Finance Exa m roo m Post Lean
  13. 13. 2. Human Resources
  14. 14. Evaluate complication on Diabetes’ Day Post - LEAN
  15. 15. • Prepare appointed OPD card in advance • Self completion in each service point 3. Concised Process
  16. 16. 4. Developed tools • Medical reconciliation sheet • Colored checklist sheet
  17. 17. Educational tools and • Mutimedia educational channels
  18. 18. Result Measure Pre LEAN Goal Post LEAN Outcom e Service points 8 - 8 same Human Resources 12 - 11 decrease d Steps in service 27 3 step 24 3 step Time taken (Minute) 141.2 10 % 62.2 55.95 % Length 111 10 % 77 30 63 Quantitative
  19. 19. Measure Pre LEAN Goal Post LEAN Outcom e Efficiency service (%) 33.36 10 % 65.90 32 54 Satisfaction High to Highest level -External customer (n=50) 84.77 81.55 incre ased incre 93.22 92.21 increas ed increas Result Qualitative
  20. 20. Diabetic patients’Satisfaction (n=50) Mean Score Pre LEAN Post LEAN p- value * Convenience and speed in service The speed of the process is available (From visit to go home) 3.44 4.10 < 0.001 * System managed service is a first (Queue system) 4.36 4.56 0.219 Providing a quick and easy dispensing 3.62 4.24 < 0.001 * Quality in service Available tools 4.04 4.26 0.063 Personnel have knowledge and talent in service 4.04 4.58 < 0.001 *
  21. 21. Conclusion • Utilizing LEAN concept can lead to substantial improvement in quality and efficiency of healthcare service (DM clinic) • Key success factor: Lean concept technique and Good teamwork
  22. 22. Thank you

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