07:24pm Thursday 14 December 2017

Urology aims to get ‘lean,’ improve patient care

Delivering the best care to every patient, every time is a common phrase in today’s patient-centered care world.  Dr. Hunter Wessells, chairman of the Department of Urology, kicked off a planning meeting in June by admitting that he’s not quite there yet in terms of his own performance.  It was a brave and honest statement—everyone has room to improve, really.

Wessells, Dr. Bill Ellis, Clinic Manager Nancy Eberhardt and Dr. Tom Walsh are leading a quality improvement project to improve patient and staff satisfaction.  The project is known as U-FIT (Urology Flow Improvement Project), a collaborative effort between UW Medical Center, the School of Medicine and UW Physicians.

Mary Guiden

Bill Ellis, UW professor of urology, talks with lean expert Naomi Maxey about the U-FIT project.The Urology Clinic is already faring well in keeping patients happy and healthy.  In an ongoing hospital initiative, the clinic is the first to have had every patient rate the experience a nine or a 10 (out of 10) on patient satisfaction.  The clinic’s ratings have been consistently on the higher side since the rating system started, too.

Bill Ellis, UW professor of urology, talks with lean expert Naomi Maxey about the U-FIT project.

Urology leaders and staff are working closely on U-FIT with Naomi Maxey, consultant in Performance Improvement/ Lean at UW Medical Center.  Lean is a term typically used in manufacturing, though it’s now spread to the healthcare field.  It refers to eliminating wasteful processes or procedures, or any action, process or product that adds cost without adding any value for the customer.

How does that translate in medicine?  Waste can occur in terms of time, for example.  The project’s goals are to improve patient flow during clinic visits, and to improve daily clinic flow.  Maxey’s work with the department entails developing measures to monitor clinic flow and improving patient, staff and provider satisfaction.

Wessells outlined the AIDET (acknowledge, introduce, duration, explanation and thanks) guidelines as part of the Patients are First and lean process.  “We need to give the patient time to express all concerns,” he said, while discussing the typical visit.  “Sometimes, a patient’s experience is related to their perception, regardless of how good the care actually was.  If we deliver great care but they think it’s terrible, we’re stuck,” Wessells said.

Ellis said that the number one predictor of patient satisfaction is being seen on time.  He shared a story of his own personal experience with his dentist’s office being efficient, and how his appointment runs smoothly.  “With the growing need for our services, I’m finding it harder and harder to keep up with my schedule,” he said, candidly.

In one activity held in July, patients were armed with clocks and recorded the length of time spent in the waiting room, wait for a doctor and length of the appointment.  Clinic staff and providers took on the role of observer to gain a better understanding of the entire process and how individual roles fit into the process.  It’s a novel approach that was perhaps a little nerve-wracking, but also eye-opening for the urology team, as staff reported back that they really learned from each other.

“We hope to become the shining example of putting our patients first at UW Medicine,” said Walsh.


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