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Lean workflow helps streamline patient visits, improve focus on quality measures

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This article was originally published in March 2010.

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“It was an eye-opening experience,” Bill Neighbor, MD, said about the Lean workflow training that Qualis Health provided to the staff at University of Washington Medical Center – Roosevelt. “It generated a lot of enthusiasm to make patient visits more efficient—and a better experience for both patients and ourselves.”

Qualis Health led the UWMC team, which included front desk staff, MAs, PAs, social workers, and physicians, through the process of mapping a typical patient visit. Bringing everyone together helped the various staff better understand the broader picture and realize just how much time was being spent on redundant tasks. “We needed a more efficient way to get health maintenance information and medication lists from the patient. We didn’t have an organized system for handling that on each visit,” Neighbor explained.

Qualis Health guided the team to make better use of their existing electronic health record (EHR) system. A previously unused feature, the pre-visit summary, became an elegant solution. It efficiently moved the data-gathering step to the beginning of the visit, allowed for more patient activation as they completed the information themselves, and provided a structured means of transferring that data back into the EHR—where it can be reviewed in subsequent visits and become part of monitoring reports.

“Now we have a more systematic means of capturing data when patients get immunizations or mammograms outside of our office,” Neighbor said. “As a result, our quality measure reports are more complete.”

“Focusing on the project’s four measures [pneumococcal and influenza immunizations, mammograms, and colorectal cancer screening] brought up lots of questions regarding our entire process of care,” Neighbor said. “The project has really gone well and we’re getting ready to spread some of the changes to our system’s other clinics.”