In healthcare, over-processing usually takes the form of patients being treated longer, and often more extensive, than is needed. From filling out excessively long forms to tests that aren’t needed, there are many ways we can trim our process, stay within care guidelines, and cut waste.
Unlike other industries, healthcare’s funding model sometimes pays for over-processing, which puts clinics in the awkward spot of either increasing the efficiency of the medical system overall or looking to their balance sheets. Other cases of over-processing are truly internal, and clinics must identify and confront them like any other industry.
Over-processing waste often starts at first contact, especially with new patients. When they fill out the form, how many data fields are you actually going to use? If you’re not planning to email them, for example, why ask?
Are patients filling the forms out long hand? This can cause spin-off frustrations (who moved the clipboard?), as well as potential data-entry time. Every time someone has to read or interpret handwriting, we’re opening the door for additional waste.
Why not have a tablet accessible so patients only fill out the form once and the data syncs to whatever other forms are required? Not all patients may be comfortable using that technology, but those who are can save you data entry time and potential mistakes.
What does the Patient Need?:
When a patient needs additional treatment after the first appointment, over-processing can happen a number of ways:
- Referring to a Specialist when a Primary Provider can provide the same care
- Ordering unnecessary testing, like asking for an MRI when an X-ray would yield the same answers
- Requesting surgical intervention when there’s an available and effective medical alternative
Sometimes this over-processing waste will actually add efficiency at the clinic level because it moves the patient to excessive care elsewhere. But Lean thinking emphasizes optimizing value at the broadest level, and adding waste to the system as a whole decreases value to the patient overall.
The key to nipping over-processing in clinics, as it is with other industries, is to enforce the standardized referral practices. Training and reinforcing documented referral guidelines with your medical staff will keep rules clear and help avoid over-processing causing procedures and tests.
We often ask for follow-up appointments with patients. These are often valuable tools for connecting and checking progress. Sometimes, however, they’re redundant.
If a follow-up exists to simply check in and ask one or 2 questions, consider a phone call or a virtual Skype call instead of in-person.
Unfortunately, how clinics are reimbursed and Lean thinking don’t always go hand-in-hand, and reducing follow-ups may not always be in the clinic’s financial interests. However, as far as overall value goes, we need to consider everywhere that over-processing happens.
Audit your Tasks:
Your staff perform some processes dozens of times a day. As with Motion, the priority we should give to focusing on any task for process improvement correlates with how often we do it. Math doesn’t lie.
Choose a process and map out every step taken in it. If you have a pharmacy in-house, for example, how many steps does it take from the doctor’s chicken scratched Rx, to the pills being handed over, to documenting after the fact. You might find that a dozen or more steps can be safely and substantially reduced.