Buzzword for 2009… LEAN – Another Reader Contribution

It’s hard to believe it’s already the first Wednesday of the New Year. This post comes courtesy of Sharon Ruth of MDSIS (a DMGMA Sponsor). Sharon and Jim Jones of DEMEP will be providing a continuing series of articles on LEAN managment.

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Many of you have heard about lean, maybe read a book addressing practice management, or attended a seminar on how lean can improve your practice.  Lean, is a philosophy that aims to provide the best quality at the lowest cost in the shortest time through eliminating waste.  In essence, lean means doing more for your patients with less.

 To assist you in learning more about lean, this entry will address patient wait time, which is THE biggest complaint, heard from many of your patients.

A Press Ganey survey reported that patients will “tolerate” a wait of up to 20 minutes.  Patient loyalty is at risk when the wait EXCEEDS 10 minutes.  Based on a million patient surveys, the average patient satisfaction score drops from 92.6 percentile for waits less than 5 minutes to 89.8 for waits 6 to 10 minutes, and to the 84.3 percentile for more than 10 minutes.  But, before you make improvements, you need to understand how long they really wait in your practice. 

Cycle time, a lean term that means the measurement of time from the patient’s entry to the patient’s exit.   The average cycle time in a physician practice ranges from 30 to 90 minutes, with 60 minutes as the average.  This time period can be divided into two categories: customer Value Added steps (what the customer is willing to pay for) and Non-Value Added steps (what steps a customer is not willing to pay for but necessary to the practice getting paid).

To look at your practices’ cycle time, involve your patients.  You don’t have to conduct the timing survey. Simply, set up a procedure that involves your patients.  For instance, track from the moment they sign in to the moment they depart.  Remember, the average time is 60 minutes, depending on your practice (services offered, consults and ancillary services may take longer) this average time may be greater.

Your cycle time will depend on the services your practice offers and may differ by patient.  So don’t try to aim for a particular time, but improve Value to the patients in each of your process steps.

Your practice goal should be to streamline and optimize value added steps, and to reduce and eliminate non-value added steps.  Once complete, these goals allow you to improve quality by reducing waits and delays for the patient.

There is no perfect cycle time, but if you optimize the value added time (the encounter between the patient and the physician), eliminate the non-value added time (asking for insurance information for the 5^th time, etc.) you create a win/win situation for you and your patients.

To learn more about lean please contact Jim Jones @ DEMEP (jjones@demep.org) 302-283-3135 or Sharon Ruth @ MSDIS (sruth@zutzgroup.com) 302-397-0173