Improvement of outpatient pharmacy through patient participation and Lean methodology.

Abstract

Objective: To improve the quality of the dispensing process and  pharmaceutical care in the Outpatient Pharmacy through patient participation and Lean methodology, and to analyse the results obtained in  terms of efficiency and patient satisfaction.

Method: Prospective observational single-centre study. A working group was  organized with the health care staff involved in outpatient care to apply Lean  methodology and detect improvement opportunities. We used a focus group  technique to understand the patients' experience. The impact on patient  satisfaction was measured through a mass survey mailed out in December  2019 (before introducing the main measures) and in December 2020.

Results: More than 30 improvement actions were identified after surveying the opinions of the patients and health care staff involved. Nine actions were prioritized, which were mainly related to structural and circuit changes. Waiting times significantly improved (35% of patients waited for more than 30 minutes before the improvement actions vs 4.5% afterward). The results showed that waiting times and overall  satisfaction significantly improved in the period between the two surveys. In both cases, the degree of satisfaction was higher after introducing the improvement actions.

Conclusions: We analysed the situation of our Outpatient Service and designed the most appropriate improvement actions according to the resources available. This initiative was achieved through patient  participation (via a focus group and mass surveys), the participation of health  care staff, and the application of Lean methodology.