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Making your practice more patient friendly

How can lean businesss processes used in industry be incorporated into general practice? By Roy Coldwell

Roy Coldwell: reduce any waste
Roy Coldwell: reduce any waste

Lean principles were pioneered by the car manufacturer Toyota in the 1960s, but it is only in the past decade that other sectors, including healthcare, have embraced its benefits.

The main philosophy behind lean is the streamlining of processes through the continual elimination or reduction of waste.

In manufacturing, the ideal is to operate a 'just in time' system whereby only the resources necessary to complete the job on time, on budget and to the customer's satisfaction are deployed when required.

The same outcome can be achieved in a GP surgery, where the patient is the 'customer'.

Assess the status quo
The first step to a lean surgery is to identify the state of affairs.

This entails mapping out every process from start to finish and should involve all staff.

It will include the patient's journey and other tasks such as ordering supplies, preparation times, receiving calls, specialist clinics and GP visits.

It should also consider how long each task takes, average appointment times, how information is recorded and exchanged, the sequence of events, what triggers the work and time of day.

Lean is all about adding value. From your mapping exercise you should be able to identify those aspects of the work which do not add value and take steps to reduce or eliminate them.

System continuity
Waiting and unnecessary movement are all forms of waste. Aim for a continuous flow, so that patients are moved quickly and seamlessly through the system.

One way of ensuring this flow and improving patient experience is by avoiding 'batching'.

So aim to send samples to the lab as soon as you take them, rather than waiting for several to be available. This should eliminate waiting and patient stress and reduce the number of patient phone calls to reception.

Try to assess how long an appointment will take by the nature of the symptoms. Does the patient need to come into surgery, or can this be dealt with over the phone?

Similarly, if a patient needs appointments with different personnel, it would be more efficient to schedule them on the same day in succession and, if possible, in the same room.

Many surgeries already use a system where the patient checks themselves in on a computer screen, avoiding delays and allowing the receptionist to take calls or progress other tasks.

If a follow-up appointment is required, could the GP have access to a calendar and book the patient in instead? Could test results be emailed to patients over a secure server?

There will be a number of patients who visit the surgery for repeat prescriptions. Would it be possible to issue a prescription for several months' medication and then schedule a check-up after that time?

Start small. Any change that saves time or avoids duplication of work will improve flow, patient satisfaction and staff morale.

  • Roy Coldwell is operations director at Picme Limited, one of the country's leading business improvement companies.

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