Decreasing Turnaround Time and Increasing Patient Satisfaction in a Safety Net Hospital-Based Pediatrics Clinic Using Lean Six Sigma Methodologies

Qual Manag Health Care. 2016 Jan-Mar;25(1):38-43. doi: 10.1097/QMH.0000000000000083.


Objective: Increasingly, health care quality indicators are focusing on patient-centeredness as an indicator of performance. The National Quality Forum lists assessment of patient experience, often conducted using patient surveys, as a top priority. We developed a patient-reported time stamp data collection tool that was used to collect cycle times in a safety net hospital-based outpatient pediatrics clinic.

Methods: Data were collected using patient-reported survey to obtain cycle times in Pediatric clinic, as well as qualitative and quantitative patient satisfaction data. Several rapid-cycle improvements were performed using Lean Six Sigma methodologies to reduce cycle time by eliminating waste and revise unnecessary processes to improve operational effectiveness and patient and staff satisfaction.

Results: A total of 94 surveys were collected and revealed average cycle time of 113 minutes. Our measured patient satisfaction rating was 87%. Discharge and check-in processes were identified as the least efficient and were targeted for intervention. Following implementation, the overall cycle time was decreased from 113 to 90 minutes. Patient satisfaction ratings increased from 87% to 95%.

Conclusions: We demonstrate that using Lean Six Sigma tools can be invaluable to clinical restructuring and redesign and results in measurable, improved outcomes in care delivery.

MeSH terms

  • Ambulatory Care Facilities / organization & administration*
  • Ambulatory Care Facilities / standards
  • Efficiency, Organizational
  • Humans
  • Patient Satisfaction*
  • Pediatrics
  • Process Assessment, Health Care
  • Quality Indicators, Health Care
  • Safety-net Providers / organization & administration*
  • Safety-net Providers / standards
  • Time Factors
  • Total Quality Management / organization & administration*
  • Workflow