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Application of Lean Sigma to the Audiology Clinic at a Large Academic Center
Matthew G Huddle1, Amy Tirabassi2, Laurie Turner2
1Johns Hopkins Department of Otolaryngology-Head and Neck Surgery, Baltimore, Maryland, USA mhuddle2@jhmi.edu.
Objective:
To apply Lean Sigma--a quality improvement strategy to eliminate waste and reduce variation and defects--to improve audiology scheduling and utilization in a large tertiary care referral center. The project goals included an increase in utilization rates of audiology block time and a reduction in appointment lead time.
Study Design:
Prospective quality improvement study.
Setting:
Academic tertiary care center.
Subjects:
All patients scheduling audiology clinic visits July 2013 to July 2014.
Methods:
Value stream mapping was performed for the audiology scheduling process, and wasteful steps were identified for elimination. Interventions included a 2-week block release, audiology template revision, and reduction of underutilized blocks. Schedule utilization and lead time for new patient diagnostic audiogram were measured for 5 months postintervention and compared with 5 months preintervention. Overall, 2995 preintervention and 3714 postintervention booked appointments were analyzed.
Results:
Block utilization increased from 77% to 90% after intervention (P < .0001). Utilization of joint-with-provider visits increased from 39% to 67% (P < .0001). Booked appointments increased from 2995 to 3714, with joint-with-provider booked appointments increasing from 317 to 1193. Appointment lead time averaged 24 days postintervention, compared with 29 days preintervention (P = .06). Average monthly relative value units measured 13,321 preintervention and 14,778 postintervention (P = .09).
Conclusion:
Lean Sigma techniques were successfully used to increase appointment block utilization and streamline scheduling practices.
