Lange, Wells (1991, ASQC) Wells Lange Associates, Niwot, CO
The A.F. Williams Family Medicine Center in Denver, Colorado, recognized the need to reduce an unacceptable amount of waste and rework and implemented a Quality Improvement project that used System Analysis. The main goals were to minimize patients' pre-treatment and post-treatment times and to improve appointment scheduling so doctors met with patients as close to the scheduled time as possible.
System Analysis involved data gathering, charting, and process analysis to identify opportunities for improvement in the quality of health care. Personal interviews and meetings with employees led to a better understanding of the current processes. Seven activities were then charted chronologically on process flow charts: sick call, emergency sick call, appointment call. patient question, prescription refill, outside physician call, and nursing home call.
Analysis of the flow charts indicated that Patient-Customer requirements were sometimes incomplete or not passed on to the staff members needing to know and act on them. Also, key personnel were not always available when needed, intra-staff communications were poor, laboratory tests did not always provide needed information, telephone lines were used excessively, and Patient-Customers were not always available when scheduled.
Although the quality improvement projects described in this paper are not complete, they offer a better understanding of quality improvement techniques used in the health care field.
Health care,Rework,Systems analysis,Waste,A.F. Williams Family Medicine Center