Leaninclinic 130904014143-

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Leaninclinic 130904014143-

  1. 1. Using LEAN concept to increase efficiency in Diabetic clinic service, Public Health Center 67 Taweewatthana Suthee Saritsiri, MD Director of Public Health Center 67 big_bossboom@hotmail.com
  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. 4 Potential mechanisms of management within the organization. Strengthen the personnel and the potential quality of life and pride. Allocate the necessary resources. 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 Patients Visit monthly NPO for DTX Unsatisfie d emotion Well glycemic control Healthcare providers may not be tired. Loss F/U Increased risk of complications morbidity mortality Win – Win: Between patient and staff satisfaction
  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 March 2013 External Customer need SWOT Analysis
  8. 8. Outcome evaluation Quantitative Qualitative 1.Physical environment: No. of service points 2. Human Resources: No. of Healthcare providers 3. Process: No. of steps in services 4. Time and Length: in each steps of services (start to the end) 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 room Pharmacy room Finance room Exam room. Exam room. counseling room Health education room preparing Cue cards Elevator Waiting Point Service Cue cards Medical records room preparing Nursing room Examination room Counseling room Finance room Pharmacy Pre Lean
  11. 11. Door Nursing room Medical records room Pharmacy room Finance room Exam room Exam room 2 counseling room Health education room preparing Cue cards 1 Elevator Waiting 7 8 Floor 1 Post Lean
  12. 12. Blood exam counseling room X-ray room 3 5 Elevator Waiting preparing 4 2 6 Screen 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 Exam room 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 Outcome Service points 8 - 8 same Human Resources 12 - 11 decreased Steps in service 27 3 step 24 3 step Time taken (Minute) 141.2 10 % 62.2 55.95 % Length (Meter) 111 10 % 77 30 63 % Quantitative
  19. 19. Measure Pre LEAN Goal Post LEAN Outcome Efficiency service (%) 33.36 10 % 65.90 32 54 Satisfaction High to Highest level - External customer (n=50) - Internal customer (n=50) 84.77 81.55 increased increased 93.22 92.21 increased increased 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* Doctor followed by Clinical Practice Guidelines 4.60 4.64 0.753 Courtesy and empathy Personnel have service mind 4.76 4.86 0.307 Personnel attention and caring as well 4.68 4.72 0.752 Personnel advice in good verbal and polite 4.60 4.80 0.064 Give information about health care and service Give in patients’ need 4.56 4.60 0.756 The pharmacist explains how to use each drug clearly 4.28 4.28 1.000 Adequate information and channels 4.04 4.48 0.005* Service charges and costs Delight in the service charges and costs 4.80 4.74 0.587 Compare between cost and services received. Worth? 4.82 4.90 0.377 Building and facilities Separate property. Easy to use 4.74 4.86 0.244 Safety 4.82 4.84 0.841
  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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