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Annual Health Physical: Lean by design


I recently attended my annual check-up and physical by my primary care doctor.   A number of things seemed different this year.   My doctor knows me quite well, and he knows about my professional interest in LEAN.  So he was excited to talk about what has changed.  My experience as a patient was completely different this year, accelerated by a grant to implement LEAN in his office.   If you are a health professional and want to delight your patients, take this piece of advice.  Go Lean.

So, what did the experience look and feel like for the patient after the implementation of Lean?  From the minute I walked in the door, I experienced many improvements.

1. No delays or queue.

There was no waiting at the front desk.   All of my records are now on the new EMR (Electronic Medial Records) system.   No copies were needed of my insurance card.  No questionnaires to fill out.   Only one quick form to sign for HIPAA.

2. No waiting once checked in.

I sat down in the waiting room, expecting to wait for a few minutes.   I had just signed my HIPAA form and was preparing to bring it to the front window, when the nurse called me in, “Timothy?”   At first, it didn’t register.

“Timothy?” she called again.

“Ah, was that Timothy you called?”, I replied.

“Yes,  Is that you?”

“Ah …Yes. I still have the form they asked me to sign.”

“No problem she said, I’ll take it.”

No wait time.  No division of duties.  Pretty smooth so far.

3.  Improved Flow

I noticed that the flow path to the room had improved.  Now the scale and height gauge were right on the way to the room.   “Umm, do I need to take off my shoes?”   “No it’s fine” said the nurse, ” We just need an idea of your approximate current weight.  It’s up to you.”  (No over-processing here.)

Well, I did take them off knowing that I had put on a few pounds since my last visit.  (1o pounds to be exact – It’s been a long winter in Michigan).

4.  Work area ready for the patient (5S)

On the way to the room…. the nurse stopped…there were 2 rooms to choose from.  She had to decide where to put me!  Obivously there is good flow in this office I thought to myself.  No waiting for a room.  The room was ready and everything was laid out for the physical.

5.  Excellent training and standard work

She went through the regular questions.  Everything was on their new computer system.   No paper records, only electronic records.  Very well done I thought.

She took a little time with the system (just a few seconds) and apologized since she was new.  “How new?”, I asked.   “Oh, I just started on Monday.”  Well, obviously they had standardized the work and training for her, because she was very efficient.  She then took my blood pressure, pulse, temperature, etc.   Everything went into the computer.   Then she said, “The doctor will be right in.”     So I picked up my smartphone to check my email, and before I had a chance to read one e-mail, I heard the doctor outside the room.   Then a slight knock, and there he was.  Wow… No waiting for the doctor.

6.  No rework

The doctor already had all of my information in his computer.   Everything done so far; my weight, my blood pressure, the questions I had answered, etc. ….they were all on his screen.

7.  Connected to Suppliers

When I asked my doctor for a refill on my prescription.   He said with a smile… “This is the part I love!”   He clicked a few buttons, and said, “There… it is sent to your pharmacy.”    Literally in a matter of seconds my prescription was sent to the pharmacy.

8.  Focus on the customer

My doctor spent nearly the whole visit dealing with me.  He went over everything connected to my health.  My family life, my exercise routine, my diet, yes… even my sex life.

9.  No waste

As the visit neared the end.  He said, “we are trying something new.”   Your billing is all handled in the room.   So after he left, a member of the office staff came in immediately to the room and went over the final bill and co-pays.   Everything was completed in a few seconds, and I was free to go.

10.  Total customer experience across the value stream.

I had to know… was my prescription really ready?  Will the pharmacy be as efficient?  So I went directly to the pharmacy after the appointment.  And yes.   The pharmacist had the prescription waiting for me.  And when he saw me come in, he brought my prescription to the front counter.  I was in and out of the pharmacy in a matter of 5 minutes.

So LEAN in Healthcare can make a huge difference in patient experience.   Congratulations to Dr. Terrence Wright and the staff of his office.