As a physician, you want to give your patients the best care and user experience to make them feel at ease and, ultimately, healthy. But we all know it’s not as simple as that. A number of stumbling blocks prevent physicians from working at their optimum level of efficiency and this ultimately results in poor patient care. In this three part series, we highlight ways you can tackle some of the key issues affecting physicians’ practices today. This first part looks at how mapping workflow can increase efficiency.
Managing and mapping workflow can be one of the biggest contributors to the success of a physician’s practice. Workflow inefficiencies cause delays for patients, resulting in poor customer service as a result of the frustration experienced by support staff as well as the burnout experienced by physicians themselves. The key to running an efficient and effective clinic is simple: recognizing and eliminating waste and thereby improving workflow.
It is estimated that up to 40 percent of clinical office work is redundant or otherwise wasted effort. Value stream mapping is a process that has its roots in Lean Management and that can help practices identify workflow inefficiencies by identifying and minimizing waste in a process.
By means of a visual representation of a particular process, the value stream map helps you to identify steps that are unnecessary and do not add any value, i.e., waste, as well as those that do add value. For example, the process of patient care within a physician’s office can be mapped by charting a patient’s journey from the moment they make a doctor’s appointment to the moment they leave the clinic. You want that patient to leave feeling that they have received value for money, and, to that end, you are able to evaluate their journey by identifying which steps aren’t adding value and eliminating this waste.
Let’s look at how we can use this example to follow three steps in value stream mapping:
Defining the current workflow
Begin by collecting primary data from your patients that simulate their firsthand experience. For example, you could shadow individual patients and record how long each step takes. The next important stage is to engage all your staff in the process. This is imperative, because each staff member will have their own understanding of workflow. By involving the whole team, you’re able to highlight those areas that some staff may not be familiar with or even know the existence of. Begin by mapping out your current process, being sure to include every single step, no matter how small it may seem. This needs to be a comprehensive and detailed order of processes, not merely a general overview. You can then analyze the primary data based on the current workflow you have created, add any steps you’ve missed, and evaluate how long each step takes, to gain an understanding of the patient’s experience of the process.
At this stage, you’ll need to individually analyze every single step in the workflow you have just created in order to ascertain whether the step is adding value or creating inefficiencies. For example, the time spent putting a patient on hold when they call to make an appointment is not adding value to the customer, but is, in fact, slowing down the process and needs to be eliminated in order to achieve efficiency. On the other hand, time spent on patient treatment is adding value.
Creating an improved lean process
In entering the final stage, it’s important to keep in mind that an ideal and perfect process is unrealistic and that a new, improved workflow needs to be achievable. Some advocates of this lean methodology suggest creating a “perfect/ideal” process as well as another “more achievable” process before evaluating both to create a final version, looking to the utopian process for inspiration but tempering it with reality. Once again, it’s imperative to involve your team in creating a new lean process in order for staff to take ownership and ensure its success. Discuss and brainstorm the means by which the new process will be implemented and how as a team you will ensure its success.
Once the value stream mapping process has been undertaken, it’s important that it continue beyond the three steps outlined above. The implementation may be a complex and challenging one as changes are put into place and the new process is underway, but the end result will see a positive effect on the practice. It will enable not only a better patient experience, but also a more highly motivated staff, as they see the benefits of the changes that they’ve been involved in take effect.
Examples of indicators of such success include happier support staff and physicians through the reduction of stress levels, a better work-life balance, improvement in job satisfaction, and improved team dynamics, with staff “singing from the same song sheet” as they deliver processes created as a team. Similarly, customer service levels increase, with fewer complaints and more compliments, as well as increased profits as processes are streamlined and staff are required to work less overtime.
To conclude the first part of this article, we share some practical examples of ways to improve workflow in your physician clinic:
Use of technology
This is a very effective way of improving workflow; for example, electronic medical records (EMR), printers, phones, walkie-talkies, and computers can improve internal communication and ease the workload of paperwork.
Evaluation of practice sites and the staff located within them can be an essential part of workflow assessment. To improve efficiency, staff members who need to communicate regularly should be placed in the same physical location.
Standardization of rooms and equipment
This makes it easier for each staff member to understand where things are and to be able to complete check-ups and procedures more quickly and efficiently. In addition, it makes the task of ordering stock much easier.
The use of continuous workflow
Reducing the need to do work in piled-up batches, for example, by filling in documentation at the end of each visit, can greatly help to eliminate waste.
Setting up rooming criteria for different types of patients
Preparing patients for their consultations with physicians by such means as letting them know what they need to prepare can reduce time wastage.
In the next part of this series, we will look at “patient portals” to help you improve efficiency in your clinic.