Decreasing Patient Wait Times: Using Lean Methodology

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Decreasing Patient Wait Times: Using Lean Methodology

Introduction

Timely access to healthcare services is linked to improved healthcare outcomes and contributes to controlling healthcare costs in healthcare systems. Most patients utilize ambulatory primary care services for end-of-life care, disease prevention and health promotion, liaison with home care, maternity and child care, minor urgent health concerns, mental health, and routine maintenance (Ansell et al., 2017). Therefore, convenience in providing care, availability and accessibility are crucial traits of efficient and effective primary care services. Consequently, research has demonstrated that timely access to primary care improves the quality of care delivered and patient satisfaction (Carpenter, 2021). However, the shortage of healthcare professionals in most regions has resulted in an increased rate of chronic diseases and disabilities. The issue of lengthy patient wait times has been a cause of disappointment for patients, staff, and the healthcare administration. As such, this project focuses on developing and implementing strategies to improve the quality of care and decrease patient wait time in the healthcare systems.

Overview of the Problem

The average wait time for the City Department of Public Health (CDPH) clinics was 58 minutes, but it takes over an hour to complete all the processes required in the clinic (Carpenter, 2021). According to CDPH (2018), each provider can serve a capacity of over 20 patients per day; however, due to lengthy wait times, the clinics can only see about ten patients a day. Therefore, the research demonstrated that the significant burden of being a patient is the lengthy wait time. Long wait times limit the capacity of a healthcare facility to provide the proper care within the right time, leading to an inefficient workflow. Additionally, a lengthy wait time for primary care can impose an emotional and physical burden on a patient who requires urgent care for their condition.

According to Ansell et al. (2017), adverse impacts may result from prolonged patient wait times, such as the increased risk of morbidity and mortality for patients with cancer and heart diseases; rapid decline in health conditions for patients with mental disorders; higher costs; and finally, lengthy wait times dictates a client’s overall perception of quality of care and services offered by a specific healthcare system. Consequently, long wait times limit the ability of a healthcare organization to effectively and efficiently provide primary care, thus, limiting the potential for the organization’s growth (Carpenter, 2021). Therefore, by developing and implementing strategies to improve the quality of care and decrease patient wait time in the healthcare systems, this project’s strategy and implementation program will ensure enhanced timely service delivery to the patient in healthcare facilities and the nursing discipline as a whole.

Project Purpose Statement

This capstone project aims to establish and execute approaches to enhance efficacy and decrease patient wait time in the healthcare systems. Improvement in quality care would also improve health service departmental processes through the routine use of healthcare schedules and program information to meet the needs of consumers (Ansell et al., 2017).

Background and Significance

Ambulatory healthcare is the US healthcare delivery system (Carpenter, 2021). The National Ambulatory Care Survey found that approximately 400 million healthcare consumers used outpatient services, while just 30 million people were admitted to the healthcare facilities. On that account, the need for ambulatory services is very high in all hospitals; thus, high-quality care is vital in healthcare organizations (Carpenter, 2021). To satisfy the increasing need for ambulatory services, hospitals must modify contemporary care practices to improve care services. Therefore, decreasing patient wait times is critical for healthcare practice.

As stated earlier in the paper, lengthy wait times significantly impact both the patients and the healthcare systems. According to Ansell et al. (2017), prolonged patient wait times are most extensively evidenced in ambulatory care services- leading to patient dissatisfaction, interruption of work designs, and difficulty in care accessibility. Such a problem can be minimized by reducing the duration patients spend waiting for a care service. Additionally, extended wait durations could significantly affect healthcare service providers’ logistic and financial impact; thus, it can pose a problem to an organization’s operational effectiveness (Carpenter, 2021). Therefore, long wait times in providing ambulatory care services need a crucial consideration (Ansell et al., 2017).

The lean methodology would be a viable approach to enhance an organization’s efficacy in quality care by creating a smooth standardized workflow for healthcare systems (Carpenter, 2021). The approach’s primary focus is to eliminate wasteful steps in the ambulatory care process and propose a standard workflow that reduces patient wait times. Furthermore, quality care, productivity and financial challenges would ultimately be solved.

PICOT

For a patient receiving ambulatory care services (Population, P), will the implementation of a quality improvement project using Lean methodology (Intervention, I) compared to using no strategy improve ambulatory service efficacy and decrease patient wait time (Outcome, O) at the healthcare organizations within 12 weeks (Time, T)?

Population: The population includes all patients receiving ambulatory care services. These include all ages, ethnicity, colour, and genders.

Intervention: This is the implementation of quality improvement by utilizing the Lean methodology. Lean is a set of operational directions and processes that facilitate a maximum value for patients by reducing waste times (Carpenter, 2021).

Comparison: The intervention is compared to using no strategy at all.

Outcome: The expected outcome will be that implementing quality improvement using the Lean methodology will improve ambulatory service efficacy and decrease patient wait time.

Timeframe: The expected outcome should be evident in about 12 weeks after implementing the strategy.

Literature Review

A literature search was conducted to support the project question. It, therefore, assisted in pinning down data and information regarding the problem. The databases utilized for the literature search included PubMed, Johanna Briggs Institute (JBI), Google Scholar, Researchgate, and Medline. Keywords used for the search in the Google Scholar, PubMed, JBI, and Medline included clinic efficiency, ambulatory service, Lean methodology, patient wait time, improving wait times, and quality improvement. The search terms were used in various combinations and yielded 40 articles. Of the articles, a few were reviewed and used in this project. The ones selected were peer-reviewed, written in the English language, and were articles published in 2017. Most of the literature search was conducted in the US, with a minimal amount of literature found outside America due to their relevance to the project question.

A study by Godley and Jenkins (2019) found that the amount of time spent by the patient while waiting for care services has an extensive influence on the satisfaction level. Conclusion: There is a constructive interrelationship between patient satisfaction and patient wait times – as increased wait time negatively affects patients’ perception of the overall service provided by a mobile service unit. However, decreased patient wait times positively affected consumers’ satisfaction. Identical results were also found by research by Lot et al. (2018) and Hossain et al. (2013).

Hossain et al. (2017) used processes and models in simulation to explore, synthesize and improve patient flow in healthcare systems. The research used simulation replicas to establish a technologized visualization of a specific healthcare workflow to identify areas of problem and provide a required strategy for improvement (Hossain et al., 2017). Additionally, the results of their project demonstrated consistent valuable information on pinpointing the necessary factors for the patient duration at the ambulatory care services. As a result, the researchers improved patient wait time and enhanced health provider time usage.

Finally, several studies utilized the Lean methodology to increase efficiency and reduce patient wait duration in various healthcare settings. The strategy focuses on securing a continual workflow by recognizing the value in multiple process steps. Most of those research specifically utilized value mapping to analyze the actual steps involved in ambulatory care services (Lot et al., 2018; Godley and Jenkins, 2019; Valsangkar et al., 2017). This research demonstrated that Lean strategies could improve patient wait times among ambulatory care patients and enhance efficacy and overall consumer perception of a healthcare system.

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