How eliminating waste and taking fewer steps can improve patient care

Recently I was on a canoe trip in Ontario, Canada with a close friend. As he and I were portaging our gear and canoe between two lakes I was thinking that the uphill path was difficult and wondered how many more steps it would take. The sooner it was done the better.

I often find myself counting steps during my daily activities as I know that the fewer physical steps it takes to accomplish a task, the more time I have for the important things in my life and work. The only time I appreciate taking more steps is when I walk with my wife or go for a jog. Otherwise, the fewer the steps the better.

Taking fewer steps is beneficial in health care too. Unnecessary steps detract from quality time with patients. Consider, if you would, the amount of time and steps that can be wasted searching for and filing patient health records at a primary care site. In a recent article on the iSixSigma website, “Lean Improves Physician Office Medical Records Flow,” the authors described how medical charts at one family practice could typically be found in any one of 39 different places. The staff typically spent 7 hours a day looking for missing charts. Applying quality improvement techniques, the time was cut to 2 hours a day. Fewer steps and more time for the patients!

John Black in his book The Toyota Way to Healthcare Excellence describes several instances of saving steps at health care sites. He states that at Park Nicollet Health Services applying lean strategies saved the staff 265 miles of walking each day. This not only increased the amount of time clinicians could spend with patients, it also increased patient throughput, thus increasing revenue.

As you go about your work think about the steps that you take. Are any wasteful? One good place to start thinking about steps is with supplies or medication. Were the items you wanted close by? Were they in stock or did you have to find a substitute? Having the correct supplies located near the point of use and continuously replenished saves many steps and lets the clinician focus on the patient.

Continuously finding ways to eliminate such waste at health care sites so as to increase quality time with patients is not a common enough practice. However, finding ways to cut waste—such as decreasing the amount of time spent walking—increases time with patients and improves patient care outcomes.

Donald Tex Bryant is manager of Bryant’s Healthcare Solutions, LLC.

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  • R Watkins

    I thought walking was good. Do we really want to create work environments where physical activity is reduced to a minimum?

  • HospiceDoc

    That’s interesting. The most inefficient place I have ever worked was the VA. No motivation to save physician time or take menial tasks out of the doctor’s realm there.

  • EKB

    Here in Mexico, patients are often in charge of their records. We get a test or x-ray, we get the record and report. We bring it to the doctor and bring it home and keep it. Doctors of course keep their notes. This sounds wildly primitive, I suppose, but in fact, we can bring all our records to each doctor so they can see everything. Of course, they don’t have the reports themselves on hand when we aren’t seeing them.

  • will6

    This is why I believe that truly interoperable electronic health records will be of value; patients can manage their own records, and incorporate blood glucose levels, exercise and blood pressure and have a fully comprehensive picture of their personal health. PHRs, such as HealthVault and Google Health are a start from the patient side, but they need to be able to link up to an EHR to make it fully functional. It will save the doctors time and the patients time, so both will have fewer steps.

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