Using Lean concept to increase efficiency in DM clinic service more information please contact big_bossboom@hotmail.com

1. efficiency in Diabetic clinic
service, Public Health Center 67
Taweewatthana
Suthee Saritsiri, MD Director of Public
Health Center 67

2. • Public Health Center 67 was
established in 2007.
• DM clinic opened service in 2008.
Background
-
6,445
*100
8,843
*122
12,339
*172
15,221
*214
20,600
*295
Patients * Registered DM patients
2008 2009 2010 2011 2012

3. By
1. Providing accurate, fast, through, and
fair (good Governance) service
2. Development benefits to the
organization and society.
3. Monitoring and evaluation of customer
satisfaction.
12 years Development Plan
Bangkok Metropolitan
Administration’s Policy
5th Strategy: Develop a model management
system of sustainable metropolis

4. LEAN concept
Be better

5. Using LEAN concept to
increase efficiency service .
DM
Pati
ents
Visit
monthly
NPO
for
DTX
Unsati
sfied
emotio
n
Well glycemic control
Healthcare providers
may not be tired.
Loss F/U
Increased
risk of
complicati
ons
morbidity
mortality
Win – Win: Between patient and

6. Research question
Can LEAN concept increase
efficiency in DM clinic service?

7. Metodology of the study
1. Pre LEAN February 2012
2. Root Cause Analysis
3. Using LEAN Concept
4. Evaluate comparison Pre LEAN and Post LEAN
External
Customer needSWOT Analysis

8. 1.Time and Length in each steps of
services (start to the end)(value+nonvalue but necessary+waste)
Outcome evaluation
Quantitative Qualitative
1.Physical
environment:
No. of service points
2. Human
Resources:
No. of Healthcare
providers
3. Process:
No. of steps in
1.Efficiency of
service %
= value Time x
100
Total Time
2. Satisfaction:
DM patients and
Healthcare providers

9. Implement LEAN concept
1. Physical environment

10. Door
Nursing
room
2 Medical
record roomPhar
macy
Finan
ce
room
Exa
m
room
.
Exa
m
room.counsel
ing room
Health
educat
ion
room
prepari
ng
Cue
cards
Elevat
or
Waiting Poi
nt
Service
Cue cards
Medical
records
room
preparing
Nursing
room
Examinatio
n room
Counseling
Pre
Lean

11. Door
Nursing
room
Medical
records
room
Phar
macy
room
Finan
ce
room
Exa
m
roomExa
m
room
2
counse
ling
room
Health
educati
on
prepa
ring
Cue
cards
1
Elevat
or
Waiting
7
8
Floor
1
Post
Lean

12. Blo
od
exa
m
couns
eling
room
X-ray
room
3
5
Eleva
tor
Waiti
ng
preparing
4
2
6
Scree
n
Floor 2
Poi
nt
Service
1 Cue
cards
2 Screen
BW BP
3 Blood
4 Preparing
5 Exam
room
6 Counselin
g room
7 Finance
Exa
m
roo
m
Post
Lean

13. 2. Human Resources

14. Evaluate complication
on Diabetes’ Day
Post -
LEAN

15. • Prepare appointed OPD card in advance
• Self completion in each service point
3. Concised Process

16. 4. Developed tools
• Medical reconciliation sheet
• Colored checklist sheet

18. Educational tools and
• Mutimedia educational channels

19. Result
Measure
Pre
LEAN
Goal
Post
LEAN
Outcom
e
Service points 8 - 8 same
Human
Resources
12 - 11 decrease
d
Steps in
service
27 3 step 24 3 step
Time taken
(Minute)
141.2 10 % 62.2
55.95 %
Length 111 10 % 77 30 63
Quantitative

20. Measure
Pre
LEAN
Goal
Post
LEAN
Outcom
e
Efficiency
service (%)
33.36 10 % 65.90 32 54
Satisfaction
High to
Highest level
-External
customer
(n=50)
84.77
81.55
incre
ased
incre
93.22
92.21
increas
ed
increas
Result
Qualitative

21. Diabetic
patients’Satisfaction (n=50)
Mean Score
Pre
LEAN
Post
LEAN
p-
value
*
Convenience and speed in service
The speed of the process is available
(From visit to go home)
3.44 4.10
<
0.001
*
System managed service is a first (Queue system) 4.36 4.56 0.219
Providing a quick and easy
dispensing
3.62 4.24
<
0.001
*
Quality in service
Available tools 4.04 4.26 0.063
Personnel have knowledge and
talent in service
4.04 4.58
<
0.001
*

22. Conclusion
• Utilizing LEAN concept can lead to substantial
improvement in quality and efficiency of
healthcare service (DM clinic)
• Key success factor:
Lean concept technique and Good teamwork

23. Thank you