Utilizing Lean Principles to Improve Immunization Administration Efficiency in a Pediatric Mobile Clinic Program.

Abstract

INTRODUCTION: Mobile clinics are vital health care delivery systems because they provide care to those who may not have access otherwise. Unfortunately, clinic flow on mobile clinics is often chaotic and inherently inefficient. Lean is a customer-centric methodology used in industries like health care to continuously improve processes by eliminating waste. The purpose of this project was to use lean principles to improve efficiency, as measured by total time spent receiving services, so that more underserved patients could receive needed immunizations. METHODS: Using a certified lean expert, lean principles were applied to the mobile clinic program to uniformly organize the program, simplify registration processes, and standardize clinic procedures. Time study data were collected prospectively on a total of 309 patients for 2-week periods both before and after application of lean principles. Staff used a standardized time study form to record patient visit times. Pre- and postintervention data were analyzed using unpaired t tests and nonparametric Mann-Whitney tests as deemed appropriate. RESULTS: Using lean principles significantly reduced total times spent for 1-, 2-, and 4-children families. Wait times for 1- and 4-children families were also significantly decreased. Lastly, times spent on board the mobile clinic to receive immunizations for 1- and 3-children families were significantly decreased. CONCLUSION: Application of lean principles can improve efficiency by decreasing total time spent for patients receiving vaccine services on pediatric mobile clinics.