Using LEAN Methodology to Improve Patient Flow in OB Diabetes Clinic in a Single Academic Center [18H]

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Patient satisfaction is an increasingly meaningful metric in our current health care system. Our objective was to evaluate patient flow in OB Diabetes Clinic at our safety net institution, known internally as a slow running clinic with complicated patients.


The Diabetic OB clinic at Denver Health Medical Center is a referral clinic for our city wide health care system. Because of the complex medical conditions of our patients, this clinic was overbooked and often ran late. DHMC was the first health care system to utilize LEAN methodology in health care delivery. In Fall 2014, we sponsored a 32 hour LEAN rapid improvement event to evaluate patient flow in Diabetic OB clinic utilizing procedures such as current state map, root cause analysis, present and ideal state development. Clinic observations were performed; action plans were created then implemented after the event. Pre/post surveys of patient/provider satisfaction and patient cycle time measurements were tabulated.


Patient cycle time improved 29% (77 min to 55 min), patient satisfaction by 7% (from 3.2/4 to 3.45/4) and staff satisfaction 49% (from 2/4 to 3.9/4). Patient wait time to see the provider decreased by 45% (from 20 min to 11 min).


Utilizing LEAN methodology for the first time in Diabetic OB clinic, we were able to significantly improve patient flow this subspecialty clinic. We measurably decreased patient wait time and improved both patient/provider satisfaction. In a health care system where patient satisfaction is increasingly valued, our structured event and actions improved these outcomes.

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