Introduction The orthopedics clinic at an academic medical center has low patient satisfaction rates for patients that require an x-ray and have difficulty ambulating. The project aimed to reduce the ‘non-value-added’ time during appointments by using Lean and Six Sigma methodologies and enhance patient experience. Methods An analysis of the current state was conducted using Gemba walks, interviews with subject matter experts, and an interrupted time study to assess baseline data. The project was implemented using a 3-phase Kaizen event approach. Results Interventions implemented included: 1) re-engineering patient flow and 2) standardizing appointment scheduling guidelines. The ‘non-value-added’ appointment time was measured post intervention and it decreased from 17 to 8 minutes (51%) and 87% (N = 47) of patients rated the scheduling process positively. Conclusion Lean, Six Sigma and Kaizen improvement methodologies are invaluable tools to improve operational efficiency. The implemented interventions enhanced patient experience and improved clinic efficiency.
Background: Patients with workers’ compensation (WC) insurance claims are often shown to experience inferior patient-reported outcomes (PROs) after an orthopaedic surgical intervention compared with patients without WC claims. Purpose: To compare the postoperative PROs of patients with WC claims (WC patients) versus those without WC claims (non-WC patients) after proximal hamstring repair (PHR). Study Design: Cohort study; Level of evidence, 3. Methods: WC patients who underwent PHR between November 2011 and to September 2020 were propensity score matched at a 1:2 ratio to non-WC patients according to age, sex, and body mass index. Comorbidity data were collected as well as minimum 1-year postoperative PRO scores for the Lower Extremity Functional Scale (LEFS), the Hip Outcome Score (HOS), and the 12-Item Short From Health Survey (SF-12) Physical Component Summary (PCS) and Mental Component Summary (MCS). The type of work was characterized according to national WC insurance guidelines as light (maximum 20 lbs [9.1 kg]), medium (maximum 50 lbs [22.7 kg]), or heavy (≥50 lbs) [>/=22.7 kg]. Results: A total of 30 patients (10 WC and 20 non-WC) were included. The work type and baseline demographic characteristics of patients did not differ between groups. There were no significant between-group differences in postoperative PRO scores as measured by the LEFS ( P = .488), HOS ( P = .233), or SF-12 PCS ( P = .521). However, the WC cohort showed inferior SF-12 MCS scores compared with the non-WC group (49.28 ± 9.97 vs 54.26 ± 9.69, respectively; P = .032). The WC status was also associated with an increased time needed for patients to return to full-duty work capacity (21 ± 9 vs 9 ± 8 weeks; P = .005). Conclusion: Our findings suggest that WC and non-WC patients who undergo PHR have comparable outcomes. Differences in SF-12 MCS scores and return to work time for full-duty capacity warrant further investigation.
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