Using Lean Performance Improvement for Patient-Centered Medical Home Transformation at an Academic Public Hospital.

Area of Science:

• Healthcare Management
• Primary Care Innovation
• Lean Methodology in Medicine

Background:

• Lean performance improvement (PI) has a 15-year history in healthcare, but its application in Patient-Centered Medical Home (PCMH) transformation remains understudied.
• Integrating systematic, sustainable PI methods into primary care is crucial for advancing high-value care and training future physicians.

Purpose of the Study:

• To describe the implementation of Lean methodology in a safety-net, primary care teaching clinic.
• To assess the impact of Lean on PCMH transformation and resident physician training.

Main Methods:

• Clinic leadership received Lean training.
• Dedicated protected time was allocated for a stable, interdisciplinary PI team.
• Visual management tools were introduced.
• Resident physicians were actively involved in PI initiatives.

Main Results:

• Self-assessment indicated improvements in core PCMH features.
• Successful and sustainable integration of Lean into clinic operations and resident training was observed.
• Early findings suggest improvements in clinical quality outcomes.
• Patient surveys showed enhanced patient experience.

Conclusions:

• Lean methodology can be effectively implemented in academic, safety-net primary care settings.
• Lean promotes PCMH transformation and cultivates a culture of continuous PI.
• This approach enhances both clinical quality and patient experience.