Article Text

other Versions

PDF
Restructuring of the Diabetes Day Centre: a pilot lean project in a tertiary referral centre in the West of Ireland
  1. A M McDermott1,
  2. P Kidd2,
  3. M Gately3,
  4. R Casey3,
  5. H Burke3,
  6. P O'Donnell4,
  7. F Kirrane5,
  8. S F Dinneen3,6,
  9. T O'Brien3,6
  1. 1Discipline of Surgery, National University of Ireland, Galway, Ireland
  2. 2Department of Pharmacy, Galway Roscommon University Hospital Group, Galway, Ireland
  3. 3Department of Diabetes and Endocrinology, Galway Roscommon University Hospital Group, Galway, Ireland
  4. 4Leading Edge Group, Galway, Ireland
  5. 5Department of Medical Physics, Galway Roscommon University Hospital Group, Galway, Ireland
  6. 6Discipline of Medicine, National University of Ireland, Galway, Ireland
  1. Correspondence to Dr Ailbhe M McDermott, Discipline of Surgery, School of Medicine, Clinical Science Institute, National University of Ireland, Galway, Ireland; ailbhemcdermott{at}gmail.com, www.nuigalway.ie/surgery/research

Abstract

Introduction Diabetes is a chronic disease amenable to management in the community and outpatient setting. The increasing incidence of diabetes places outpatient endocrinology services under pressure to provide a quality service in a timely manner. Our aim was to apply lean thinking to the diabetes clinic in a tertiary referral centre in the West of Ireland to improve flow, as reflected in reduced patient journey times.

Methods The project lasted 6 months, from January to June 2011. An introductory seminar on lean thinking was arranged to inform and motivate the Diabetes Day Centre staff. Two ‘rapid improvement events’ took place. Value stream mapping (VSM) was the predominant lean tool employed. Patient journeys were mapped and quantified (minutes) using timesheets allocated to each step in the process at baseline, and following intervention. Data were analysed using Minitab V.16.0.

Results VSM allowed the value-adding and problem-causing steps in the patient journey through the diabetes clinic process to be identified and addressed. Total patient journey time through the clinic was significantly reduced from 118 (±38.02) min to 58 (±18.30) min (p<0.001).

Conclusions This project reflects the successful application of VSM as a lean tool in a pilot study at our institution as evidenced by improved patient flow and a significant reduction in patient journey time through the clinic. Through the incorporation of Lean into the ethos of the hospital, we have the potential to deliver excellent care in a safe environment and in an efficient manner, while benefiting the patient, employees and tax-payer.

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.