Lean Implementation for Graduating Optimally Controlled Stable Type 2 Diabetics from Endocrine Specialty Clinic Back...

Area of Science:

• Endocrinology
• Quality Improvement
• Health Services Research

Background:

• Endocrine specialty clinics face challenges with high numbers of stable follow-up patients, limiting access for new patients with urgent needs.
• Optimizing patient flow in specialty care is crucial for efficient healthcare delivery and timely access to specialized services.

Purpose of the Study:

• To assess the feasibility of a team-based graduation program to improve access to diabetes specialty care.
• To reduce the number of stable, optimally controlled type 2 diabetic patients within the endocrine specialty clinic.

Main Methods:

• A team-based lean methodology quality improvement program was implemented at M Health Fairview.
• Eligible patients with optimally controlled type 2 diabetes were identified, educated on the graduation concept, and engaged in shared decision-making.
• A warm hand-off process with a graduation certificate facilitated the transition of patients back to primary care.

Main Results:

• Over a 6-month period, 17% (58 out of 341) of eligible patients successfully graduated from the endocrine specialty clinic.
• Weekly graduation rates varied, ranging from 0% to 83%.

Conclusions:

• The team-based graduation program demonstrated innovation and feasibility in increasing access to endocrine specialty care.
• This model has the potential to improve health system triage for new patients requiring limited-access specialty services.