400 Section - Applying Lean Management Principle of Process Mapping to Improve EMG Referral Wait Time

Objective:   To introduce Lean practices to reduce EMG referral wait times by visually depicting of current and desired future processes and identify opportunities to reduce waste. 

Background: Process mapping is a Lean method used to visually outline each step of a process to build a shared understanding of the sequence of work, roles, responsibilities, and handoffs. Common symbols for visualization include horizontal ovals, rectangles, diamonds, connector arrows and kaizen bursts. The EMG Referral Process map begins at Time of Referral (TOR) and ends at Time of Completion (TOC). This map includes all persons involved in the process and identifies key areas of waste, such as duplicated efforts, incomplete referral information, limited patient education, and lack of prioritization. Mapping is depicted in two formats: basic or the swim lane format, the latter for complex processes with multiple handoffs between participants or departments. 


Case Description:

Methods: The continual patient wait time for EMG/nerve conduction studies at a safety net hospital is sequentially examined using Lean Management Principle of Process Mapping. Visio software was utilized for mapping and informed by first hand experience from the department scheduler.

Discussions:

Results:  The mapping efforts identified specific process and outcome metrics to guide workflow redesign and targeted improvement efforts. 

Conclusions:

Conclusion: Lean is an effective management approach that aligns purpose, people and process to improve patient experience by  elimination of waste in a continuous improvement model. Process Mapping of the EMG referral process provides a starting point for complex problem solving, clarifying roles and responsibilities, and supports development of realistic timelines to reduce EMG referral wait times.