Outside eyes

Post date: January 03, 2019 by Heidi Gehris

A cardiovascular clinic recently held a second improvement event, a kaizen workshop. The clinic is part of a nonprofit regional health system with 34 unique medical specialties at several locations and more than 300 physicians.

Planning for the event began eight weeks prior, including defining the target metrics and goals for the workshop. The plan was to reduce a number of wastes, including the time required to prepare charts for patients. As we were planning, the process owner and kaizen promotion office representative each had ideas about how this might be accomplished. The kaizen workshop team—which included members from the cardiology clinic as well as other clinics within the system—also expressed their own ideas during the first day of the workshop.

On day two of the workshop week, we went to observe on the gemba ­­-- the cardiology clinic -- with big eyes, big ears, and small mouths. When the team came back to share observations and generate ideas, one surprise was uncovered: different clinics were requesting medical records and test results from outside sources in various ways. In the cardiovascular clinic, the staff were making phone calls, leaving messages, and faxing requests. A workshop team member from another clinic alerted the team to a much faster way to acquire the information: register online with the outside sources and gain access to pull the data needed. This team member worked on a small sub-team to research the external sources, create time studies on the current acquisition methods, and test the new methods. Finally, they created job aides and standard work instructions to train not only the cardiovascular clinic, but also other clinics in the health system. 

The improvement results: Time to receive outside records was reduced from more than 96 hours (4 days) per chart to less than 24 hours for routine records and less than 30 minutes for STAT records! 

Improvements are often different from what anyone imagines they might be prior to a workshop, underscoring the importance of the kaizen process. Good ideas from a team of people are surfaced through the tools utilized during a kaizen workshop. People outside the area of focus can bring new perspectives and that’s often where breakthrough ideas come from.