Using Lean Six Sigma techniques to improve efficiency in outpatient ophthalmology clinics

Area of Science:

• Healthcare Management
• Operations Research
• Ophthalmology

Background:

• Outpatient services face challenges with long wait times, reduced service quality, and patient dissatisfaction due to increasing patient numbers and resource limitations.
• This study explores the application of Lean Six Sigma, a manufacturing-derived service improvement methodology, in an ophthalmology outpatient setting.

Purpose of the Study:

• To assess the effectiveness of Lean Six Sigma in decreasing patient wait times within an ophthalmology clinic.
• To evaluate the impact of Lean Six Sigma on increasing the service capacity of outpatient ophthalmology services.

Main Methods:

• A quality improvement study comparing operational data from two five-month audits, pre- and post-Lean Six Sigma implementation.
• Identified efficiency issues through staff interviews and time-motion studies, leading to solutions like schedule amendments and dedicated clinics.
• Statistical analysis using Mann-Whitney, Brown-Forsythe, and Student's t-tests to compare patient in-clinic times, variability, and patient volume.

Main Results:

• Patient volume increased by 9% per session, from 19.4 to 21.1 patients (p=0.016).
• Median patient in-clinic time significantly reduced from 131 minutes to 107 minutes (p<0.001).
• Variability in patient in-clinic time also significantly decreased (p<0.001).

Conclusions:

• Lean Six Sigma effectively reduces both the duration and variability of patient in-clinic times in outpatient ophthalmology.
• The methodology enhances service capacity without necessitating additional financial or resource input.
• Lean Six Sigma offers a viable strategy for improving efficiency in tertiary referral outpatient clinics.