Shirl Diaz's Blog

  • Importance of continued measurement

    Have you ever held a kaizen workshop that resulted in significant improvement, only to find six months down the road that the process has reverted to the old ways and the improvement was no longer evident? Why does this happen?

  • Improving access part 5: workplace organization and sustainment

    You’ve done the hard work of eliminating your backlog so that patients can be seen when they want to be seen. You are doing “today’s work today.” But how do you sustain these improvements to keep your backlog from returning? It starts with having your workplace organized and then putting into place a robust sustainment plan.

  • Improving access part 4: reducing backlog

    You’ve matched your capacity and demand, so you are able to do today’s work today. But all those appointments scheduled out into the future still need to be addressed. This is your appointment backlog, which is really the waste of inventory—an inventory of appointments. Just like supplies, an inventory of appointments has to be managed and can cause rework. For example, instead of getting care, patients who are scheduled into the future call to reschedule and/or miss their appointments, causing more work for the care team and wasted capacity.

  • Improving access part 3: managing your capacity

    Once you understand your true demand and have modified it by shaping, reducing, and substituting, it’s time to take a close look at your capacity. In ambulatory care, capacity is the number of available appointment slots in your schedule to meet your demand. There are several things you can do to optimize your capacity once you understand how much you have and where the gaps between capacity and demand are occurring. Ultimately, you will want to maximize available capacity.

  • Improving access part 2: understanding your demand

    Now that you’ve leveled out the daily work and your care teams have the ability to focus on improvement work, it’s time to look at the current state of access in your facility. If you are not able to offer an appointment when the patient wants to be seen, you could be losing market share to others in the community who are better prepared to do so. To improve your access, you need to start by understanding your demand for appointments—how many patients want to be seen by you and/or your clinic on any given day.

  • Improving access, part 1: smoothing the work of indirect care

    As more Americans have signed up for healthcare coverage, access to primary care has become a big challenge. After waiting weeks or months for an initial appointment, some patients can get what they need from that visit. But patients who need further care are back to playing the waiting game for an appointment with a specialty provider.