Authors (including presenting author) :
Lam KHE(1), Yeung KM(2), Ko KW(2), Wong NMR(1)
Affiliation :
(1)Department of Orthopaedics and Traumatology, United Christian Hospital, (2)Specialist Outpatient Department, United Christian Hospital
Introduction :
The majority of patients attending SOPC usually spend a long queuing time (QT) between registration and assessment by doctors. The situation is worse in case of high volume load. The possible consequence will be patient dissatisfaction, and among them some may file complaints. To tackle the problem and improve quality of service, LEAN principles are adopted.
Objectives :
1. To breakdown patient’s journey in SOPC with application of LEAN principles
2. To propose and trial run the incentive program based on the analysis
3. To assess if any improvement in QT
Methodology :
The patient’s journey in UCH O&T SOPC was analyzed by using LEAN tools including value stream mapping and spaghetti diagram. Value and non-value added areas were identified. Subsequently different wastes area were spotted and further analyzed using Ishikawa diagram. Among all, the human potential muda was picked. An incentive program was initiated using PDSA cycle, which aimed to encourage the doctors to attend clinic at an earlier time (based on the booking timeslots). Quota and reward systems were introduced to doctors. The program was launched in July 2022 with the help of clinic nurses. Data was collected including total number of cases seen, QT and doctor consultation duration by Corporate Queue Management System (CQMS).
Data was collected during period from July 2022 to September 2022 (2022 Q3). Comparison was made with reference to period from April 2022 to June 2022 (2022 Q2) and July 2021 to September 2021 (2021 Q3).
Result & Outcome :
Before the launch of the incentive programs, the total number of cases seen was 10672 in 2022 Q2 and 12212 in 2022 Q3. The average QT in 2022 Q2 was 60.4min and 90 percentile QT was 104.5 min, comparing to the average QT in 2022 Q3 (27.5min) and 90 percentile QT (64.5min), there was a reduction of 33min and 40min in average and 90 percentile QT respectively. The total number of cases seen in 2021 Q3 was 13018, and the average QT was 40.9min and 90 percentile QT was 84.1min. There was a reduction of 13min and 20min in average and 90 percentile QT respectively when compared to 2022 Q3.
The incentive program can motivate and engage the staff to attend the SOPC earlier, which will subsequently shorten patient’s QT. Regular review in future may help to refine the outcome and new elements could incorporate into the cycle.
