Researchers: Eytan Blumenthal¹, Adir Sommer¹, Efrat Naaman¹, Nitai Bar¹

Background: The "Lean" management method aims to optimize various frameworks, including healthcare organizations, by identifying and correcting inefficient stages in workforce, resource, and time utilization. The Q-Flow system is used for queue management while collecting data on wait times, arrival, departure, and abandonment rates.

Objectives: To demonstrate the impact of Lean optimization based on data analysis from the Q-Flow system on patient satisfaction.

Method: A longitudinal interventional study was conducted from January 2022 to December 2024 in an ambulatory eye clinic and an eye emergency room. Data were collected from the Q-Flow system alongside human observations. The stages of scheduling, reception, and examination were analyzed, and bottlenecks were addressed. Satisfaction questionnaires were distributed during January to December 2022 and again from August to December 2024, six months after the changes were implemented.

Findings: Survey results show significant administrative improvements post-intervention. Satisfaction increased for professionalism (1–Not satisfied, 5–Highly satisfied; 4.08±1.16→4.77±0.64, p=0.0013), availability (4.00±1.02→4.44±0.94, p=0.035), and courtesy (4.08±1.11→4.77±0.64, p=0.0015). Nursing staff ratings also improved, particularly professionalism (3.22±1.83→4.19±1.27, p=0.005) and courtesy (2.68±1.61→4.03±1.23, p<0.001). Overall service (3.76±1.21→4.03±1.16) and waiting times (3.74±1.42→3.45±1.28) showed no significant change. However, perceived time efficiency (3.22±1.40→3.36±1.40, p<0.0001), reduced wait for administrative help (2.95±1.80→4.69±0.80, p<0.0001), and shorter perceived waits before treatment (2.78±1.76→3.43±1.39, p=0.0145) significantly improved. Despite these gains, satisfaction with physicians and likelihood to recommend the clinic remained unchanged.

Conclusions: Use of the Q-Flow system contributes to understanding patient flow in the clinic, serving as a basis for a “lean” improvement cycle and for improving the clinic’s satisfaction rates.

Recommendations: It is recommended to establish a baseline assessment using patient management system data, such as Q-Flow, to identify bottlenecks in patient flow within ambulatory clinics. This approach does not require significant organizational changes or extensive resources and can effectively enhance workflow efficiency and patient satisfaction.

Research end date: 01/2025