Standardizing Processes within a Community Healthcare Quality System Utilizing Lean and ISO 9000 Principles

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Lean Six Sigma

Jim Levett
Chief Medical Officer
Physicians' Clinic of Iowa

The presentation will describe the process of establishing a non-profit community alliance which provides the infrastructure for a variety of healthcare projects. The initial work was funded by an AHRQ grant, and the presentation will include issues related to establishing a community leadership forum with regular programs, using health literacy concepts in writing patient educational materials, and utilizing ISO 9001 principles to establish a controlled document system. The presentation will focus on the current project involving utilization of Lean principles to analyze and improve common healthcare processes within different healthcare provider organizations. The processes include registration, electronic transfer of information, referral, collection, and the "red flag" rule. Issues related to Lean training, team formation, kaizen events, process improvements, and cost savings will be discussed.

Our current project extends the work done under a recent AHRQ grant and addresses the hypothesis that a successful community healthcare quality system can be established by standardizing common healthcare processes using Lean and ISO principles. We began by identifying several common processes used by different healthcare provider entities/organizations: registration, scheduling, information transfer, referral, collection, and the "red flag" rule. We partnered with a large group of provider entities within our community, including both community hospitals, several laboratories, the Iowa Quality Center, the Cedar Rapids Physician Hospital Organization, and multiple provider groups.

The provider entities participated in a series of Lean kaizen events to focus on one process at a time in order to map the process for each entity, determine common issues and problems, and identify best practices. The primary goal is to streamline administrative processes that impact patient care, and eventually to create more standard work for these organizations. The Lean methodology used in the project is consistent with conventional Lean techniques. The first team addressed the issue of registration and developed the working examples for the other teams that followed. The work product of the six teams will be described and cost savings derived from the work will be discussed in detail.