For healthcare professionals who work daily with electronic health records (EHR), the challenges in these systems is well known.

In the rush last decade to put electronic health records in place, many healthcare organizations now have poorly designed systems with documentation templates that can be difficult to manage. Creating efficient systems that provide a better charting of patients is a challenge.

However, a recent report from the Mayo Clinic College of Medicine said the answer could lie in the implementation of Lean Six Sigma methodology.

They even put the theory to the test.

Increased Productivity & Satisfaction

The Department of Physical Medicine and Rehabilitation at the Mayo Clinic College of Medicine settled on the using the DMAIC approach to analyze the problem with EHRs and identify solutions. DMAIC is a Six Sigma methodology that stands for Design, Measure, Analyze, Improve and Control.

The challenge was quickly identified: limitations in the documentation system for both inpatient and outpatient therapists and occupational therapists. Specifically, a “poorly designed documentation template” that includes excessive redundancies of information. That resulted in a long, unclear patient document.

This made it difficult for therapists and other healthcare professionals to go into a patient’s records and find the information needed to help them provide the proper treatment. A major part of the problem was that neither the therapists or physicians were involved in the initial design of the documents or asked for any feedback on improving it.

The Mayo team focused on three areas for improvement: the amount of time spent by therapists with EHRs, increased staff productivity and improvement of stakeholders’ satisfaction.

The Results

Implementing Lean Six Sigma processes led to significant improvements in all three areas identified by the Mayo Clinic team.

They included:

  • Reduction in the time therapists spent interacting with EHRs from 2.8 hours per day to 1.9 hours per day
  • Increased time spent on patient care from 53% to 71%
  • Increased satisfaction levels for internal stakeholders (17% to 97.4%) and external stakeholders (43% to 80.3%)

While focused on a very specific issue, the Mayo Clinic project shows the potential for applying Lean Six Sigma to EHR issues.

And they are not alone. Dr. David Butler, writing for Healthcare IT News, has advocated for using the Lean tool of 5S to sort through problems with EHRs. He recommends creation of teams that include doctors, nurses and other healthcare professionals to put 5S into play and address specific problems.

The methodology stands for:

  • Remove any unnecessary clutter in a system or process
  • Set In Order. Find methods of storage that are effective and efficient
  • Properly clean the work area (in this case, the EHR) every day to maintain the improvements made in the Sort and Set in Order phases
  • Make these practices routine
  • Have the discipline to sustain all the positive improvements indefinitely

It’s a challenge, but 5S and other Lean, Six Sigma and Lean Six Sigma methods can lead to improvements in any kind of operation or system. For those working with outdated EHR systems, it could provide the answer they have been looking for that benefits both them and their patients.

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