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The Cath Lab at University of Texas Health Northeast had a fragmented and undefined process of scheduling catheterization appointments due to lack of proper guidelines. The objective of this lean process improvement project was to decrease patient wait times by improving communication between resources and eliminate the non-value added activities in the process.
The project team process modelled the scheduling process to identify inefficiencies and prioritize changes (Fig 1). The team used LEAN methodology to eliminate waste and came up with a new process to schedule patients in cath lab. In the new process all the non-value added steps identified were eliminated and the end result was a streamlined process. The new efficient scheduling process was designed around a scheduling coordinator and a pager (Fig 2). To ensure sustainability of changes, clear roles and responsibility were established and it was not made a one person dependent process. Data was collected pre and post intervention to compare improvements.
The project had 3 phases. Pre intervention phase was from Sep’12- Mar’13, Post Intervention 1 Phase from April’13- Jun’13 and Post Intervention 2 phase from July’13-Dec’13. The average time to schedule appointments in pre intervention period was 145mins. It reduced 36.55% to 92mins during post intervention 1 period. It further reduced by 52.8% to 68.3mins during post intervention 2 period from pre intervention baseline. The number of steps undertaken to schedule an appointment was also reduced by 54%.
Concepts and skills learned by the project team in applying LEAN methodology will be used in other improvement initiatives in Cath Lab.