Improving Care Delivery Through Lean: Implementation Case Studies

• Rationale: Identified the reason for action.
• Problem identification: Laid out the initial state of the department for this issue by conducting a walkthrough of the unit and identifying problems.
• Brainstormed about what the target or future state might look like, including measurements for verifying the managed care primary care physician list, cleaning the clerical area, and ensuring patients were seen by their primary care doctor.
• Future state: Drafted a future-state map of the workflow necessary to reach the target state.
• Gap analysis: Conducted a gap analysis to see what management and personnel, equipment and systems, and methods and flow were causing gaps or issues that prevented the team from achieving its target state.
• Solution approach: Created a solution approach to counteract the gaps identified as part of the gap analysis.
• Conducted rapid experiments: Reviewed the daily activity reports to see which insurance information could be corrected 72 hours in advance of appointments; made reminder calls to patients; redirected walk-ins to appropriate locations or appointments; cleaned the front desk area.
• Completion plan: Made a completion plan and assigned activities to specific staff with deadlines over the next 90 days.
• Standard work processes: Developed standard work processes for reminder calls, appointments, walk-in redirection, and verifying insurance.

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