Eye-care services are in high demand, so practices need to find ways to work more efficiently. One way to do this, says Elizabeth Monroe, COE, CPSS, PHR, and Laurie Brown, MBA, COMT, COE, CPC, CPMA, LSSYB, BSM Consulting, a division of VMG Health, is to use lean principles, a method that helps reduce waste and improve quality. Lean principles can help an ophthalmology practice lower patient wait times and enhance patient satisfaction. This requires a careful analysis of the clinical operations and the identification of areas for improvement.
 
In the course “Improve Efficiency Using Lean Principles,” led by Ms. Monroe and Ms. Brown, attendees learned how to use lean principles to optimize their operations. Areas of focus were how to address the challenges of scheduling and patient flow that arise from the high demand for services, along with a discussion on how to reduce wait times, enhance practice performance, and increase patient satisfaction.

In the discussion of identifying process waste, Ms. Monroe and Ms. Brown identified wasted time as: High wait times, delays in completing work, unnecessary movements or steps, outdated or overly complex processes, manual processes, poor scheduling, and uneven workloads. Non-wasted time, they said, includes training, improvements to processes, evaluation of scheduling improvements and time studies. 

A case study was also presented that looked at a practice and the issues it was facing — long patient wait times, online complaints, staff frustration, appointments booked out 5 months in advance, and the team missing lunches frequently and leaving the clinic late each day. 

The presenters suggested building a business case to improve the issues, asking the questions: What are the risks associated with the project? What will be our human resources investment? What is the feasibility for our success? What is the schedule or timeline for completion?
 
The presenters also suggested following these five steps: 
 
1. Define the problem and the goal of the improvement
2. Assess the risk and the benefit of the improvement
3. Estimate the cost and the time required for the project
4. Evaluate the feasibility and the impact of the improvement
5. Create a plan or a timeline for the project

In addition, some pearls they noted that can help practices track time include: time trials (key for efficiency); time metrics (log tech, dilation and wait times); patient interaction (track all touch points); workplace efficiency (cultivate awareness); and technical training (solidify essential skills).