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Using Lean Six Sigma to Reduce Patient Cycle Time in a Nonprofit Community Clinic

Kovach, Jamison V. PhD; Ingle, Dhanashri MS

doi: 10.1097/QMH.0000000000000215
Quality Management Applications

Background and Objectives: The mission of nonprofit health care clinics is particularly challenging to fulfill given the large number of uninsured and underinsured people they serve. In addition, these clinics feel pressure to provide services in an efficient manner to prevent patient no-shows and encourage the continuation of medical care. These challenges tend to increase further when clinics feel they have exhausted their internal resourcefulness relative to their effort to improve patient care. Without additional guidance, it can be difficult for organizations to achieve additional performance improvements. To address this problem, a case example is presented that demonstrates how one nonprofit health care clinic used the Lean Six Sigma methodology to help them further improve the efficiency of their clinic visit process.

Methods: This research focused specifically on the use of process analysis tools/methods to map the clinic visit process, collect and analyze process performance data, analyze the process to identify and prioritize causes of waste, and develop and implement solutions.

Results: The clinic's use of this structured improvement approach contributed to reducing patient cycle time by more than 20% and increasing patient visit capacity.

Conclusions: This research provides a rich example from which other health care facilities can learn to enhance their process improvement capabilities.

College of Technology, University of Houston, Texas.

Correspondence: Jamison V. Kovach, PhD, College of Technology, University of Houston, 4730 Calhoun Rd, Room 300, Houston, TX 77204 (

The authors declare no conflicts of interest.

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