Implementing Lean in Academic Primary Care.

Background: Lean is emerging as a quality improvement (QI) strategy in health care, but there has been minimal adoption in primary care teaching practices. This study describes a strategy for implementing Lean in an academic family medicine center and provides a formative assessment of this approach...

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Detalles Bibliográficos
Publicado en:Quality Management in Health Care Vol. 27; no. 3; pp. 111 - 117
Autores principales: Daaleman, Timothy P., Brock, Dawn, Gwynne, Mark, Weir, Sam, Dickinson, Iris, Willis, Beth, Reid, Alfred
Formato: case study research tables/charts Journal Article
Publicado: Lippincott Williams & Wilkins Jul-Sep2018
Acceso en línea:Ver este registro en EBSCOhost
Descripción
Sumario:Background: Lean is emerging as a quality improvement (QI) strategy in health care, but there has been minimal adoption in primary care teaching practices. This study describes a strategy for implementing Lean in an academic family medicine center and provides a formative assessment of this approach. Methods: A case study of the University of North Carolina Family Medicine Center that used the Consolidated Framework for Implementation Research to guide a formative evaluation. The implementation strategy included partnering with Lean content experts and creating a leadership team; planning and completing QI events and Lean training modules; and evaluating and reporting activities related to QI and training. Results: During the initial period of Lean implementation, there was (1) minimal to no change in the quality of care as determined by the Preventive Care Index (46-48); (2) a decrease patient appointment cycle time from 89 minutes to 65 minutes; (3) an increase in overall practice productivity from $8144 to $9160; (4) a decrease in patient satisfaction from 94% to 91%; and (5) an increase in monthly visit volume from 4112 to 5076. Conclusion: Lean had an uneven effect on QI in an academic primary care practice during the first year of implementation.