Application of Lean Principles to the Comprehensive Geriatric Assessment to Reduce Cycle Time.

Background: Prolonged cycle times for new geriatric medicine assessments at the Centre for Healthy Aging have reduced the capacity to see patients. Using a time series design, the aim of the project was to decrease the average cycle time for new patients during one geriatrician's clinic from 114 to...

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Publicado en:Canadian Geriatrics Journal Vol. 28; no. 3; pp. 244 - 251
Autores principales: Park, Junghyun, Lipinski, Eunice, Fisher, Pauline, Sidhu, Amanjot
Formato: research tables/charts Journal Article
Publicado: Canadian Geriatrics Society Sep2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Sep2025
      vid: 28
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      pid: 76420
      pub: Canadian Geriatrics Society
      place: Markham, Ontario
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        atl: Application of Lean Principles to the Comprehensive Geriatric Assessment to Reduce Cycle Time.
      aug:
        au:
          Park, Junghyun
          Lipinski, Eunice
          Fisher, Pauline
          Sidhu, Amanjot
        affil: Department of Medicine, McMaster University, Hamilton, ON
      sug:
        subj:
          Geriatric Assessment
          Quality Improvement
          Time Factors
          Organizational Efficiency
          Program Implementation
          Ambulatory Care Facilities
          Human
          Canada
          Aged
          Aged, 80 and Over
          Time Series
          Quality Management, Organizational
          Geriatricians
          Time Management
          Workflow
          Electronic Health Records
          Patient History Taking
          Caregivers
          Nursing Assessment
          Counseling
          Process Assessment (Health Care)
          Clinical Indicators
          Referral and Consultation
          Descriptive Statistics
          Thematic Analysis
          Task Performance and Analysis
          Summated Rating Scaling
          Scales
          Geriatric Depression Scale
          Aged: 65+ years
          Aged, 80 & over
      ab: Background: Prolonged cycle times for new geriatric medicine assessments at the Centre for Healthy Aging have reduced the capacity to see patients. Using a time series design, the aim of the project was to decrease the average cycle time for new patients during one geriatrician's clinic from 114 to 90 minutes by May 1, 2024. Methods: Lean methodology was used for diagnostics by creating a value stream map of the workflow. This informed change ideas to improve efficiency by implementing a shared note within the electronic health record for information sharing and an assessment guide for targeted cognitive testing. The primary outcome measure was total cycle time. Balancing measures were patient clinic experience scores and counseling time. Process measures included caregiver interview time, pre-clinic intake completion rate, assessment guide use rate, and nursing assessment time. Results: Total cycle time decreased 19% from 114 minutes (19 patients) to 93 minutes (33 patients). Pre-clinic intake assessment completion rate increased from 60 to 80% and caregiver interview time decreased from 45 to 33 minutes. There was 100% uptake of the assessment guide, and nursing assessment time decreased from 43 to 31 minutes. Counseling time remained stable, and the average clinic experience scores did not decline from the baseline. Conclusions: This is the first study examining potential methods to improve efficiency of the comprehensive geriatric assessment by using value stream mapping. Spread of change ideas across the centre will be examined next with the goal of increasing capacity using available resources.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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