Flerpatientbesök – ett förbättringsförslag baserat på en analys av den dagligaverksamheten vid vårdcentralen Cityhälsan Söder : En kartläggning på Blodtrycksmottagning och Astma/KOL- mottagning med hjälp av Lean

Östergötland County Council has begun to implement “Lean-Thinking" in healthcare service. Staff at healthcare service has experienced new challenges. Health care quality cannot anymore be measured only by medical treatment results, other factors are of importance, for example accessibility. The management of the health centre “Cityhälsan Söder” wished to identify problems that affect patient flow and requested proposals for improvements which could increase the number of patients cared for at Blood Pressure-department and Asthma/COL- department. For the mapping of the activities performed by a nurse during a working day, two data collection methods were used: observation and survey. Collected data were analysed in relation to the frame of reference concerning theories of Lean healthcare and logistics. Focus in the identification of problems was to improve the utilization of nursing time to allow more patient visits. In the analysis eight types of wastes are especially used: overproduction, waiting, transportation, extra-processing, inventory, motion, defects and non-utilised skills. From the healthcare logistics point of view, the cancelations problem, lack of resources and matching capacity with demand was also analysed. To increase staff knowledge of how service may work better it was suggested to take advantage of the staff's creativity by expanding the personnel’s perception of patient flow in order to match capacity with demand. Other proposals concerned waiting-list management, which aims to introduce direct time booking of upcoming patient visits at both departments, freeing administrative time that can be spent to accommodate more patients. To standardize medical examinations on Asthma/COL-departments is also a proposal. IT-solutions for both departments may also create opportunities for more patient visits. A film that prepares the patient by teaching the correct blowing technique for the visit on Asthma/COL-department may accelerate medical examinations and free time that can be used better