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Background: The Marion County Health Department Bell Flower Clinic serves an urban population in central Indiana. Capacity to see clients is an important determinant of the ability to impact STD prevalence rates in the surrounding area. Therefore, streamlining of services can have a significant effect in supporting the mission of the STD Control Program without compromising the quality of client care.
Objectives: To evaluate the impact of changes in clinic procedures on number of clients served.
Methods: Through the use of time flow analysis, queuing theory and traditional process improvement, non-clinical services were analyzed and reorganized to increase efficiency in August 2008. In October and December of 2008, two separate Lean Six Sigma projects were undertaken to address appointment scheduling and clinical services. Metrics were developed and collected starting in December 2008 to objectively measure the effect of implemented process improvements.
Results: During July 2008, there were 1102 visits to Bell Flower Clinic. During July 2009, there were 1310 visits to the clinic (an increase of 18.9%). Patient visit times for clients requiring an exam was reduced by 17.4% for men and 15.5% for women over the time period evaluated. During this period, additional services were added (i.e. HSV-2 testing) that required additional clinic time.
Conclusions: Proper modeling before and objective data measurements both before and after process improvements are critical aspects to any reorganization. This allowed clinic management to evaluate process improvements for effectiveness. In order to get an accurate measure of success of reorganization, time must also be allowed for staff to learn and implement new processes and procedures.
Implications for Programs, Policy, and/or Research: STD clinics can take advantage of several existing process improvement methodologies to improve public perception of service quality and patient capacity.