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Lean Health Care Case Report: Mercy Clinic Family Medicine

Ask Randall Huss, MD, President of Mercy Clinic, Rolla Division, what he thinks about Lean and he will tell you, “Lean workflow and workspace redesign are the most progressive and innovative initiatives we have accomplished in the last several years.”

Before Lean, the team at Mercy Clinic Family Medicine in Rolla, MO, knew their current processes were broken, but it was hard to visualize changes they needed to make to the way they did their daily tasks in their work environment. During a retreat, providers, managers, and nursing staff went through a Lean value stream mapping exercise for each process that makes up a patient care episode. This helped the team see the waste and inefficiencies in the way they were used to practicing.

After redesigning their practice workflow in their original work environment, the team had the opportunity to move to a new building intentionally designed with Lean principles, including just-in-time inventory, standardized room designs, and pods to eliminate wasteful steps. At first there was some resistance to the new layout, such as co-location of provider and care team. Resistance disappeared once everyone moved into their new workspace. Providers were able to contrast the quiet environment with their former noisy offices and experience the ease with which they could turn around and talk to their nursing team and get things done rather than having to text everything back and forth.

The new clinic layout included a printer in every exam room. Despite initial concerns, it has not been a problem for IT to support so many additional printers. The nurses particularly appreciate having printers in the exam rooms because it saves them time entering and exiting the exam room to retrieve patient orders and visit documentation.

The team designed the clinic layout to make it easy to walk back and forth between the different clinical areas to talk to a colleague or get a curbside consultation. Clinician lounges offer another opportunity for providers to interact with each other, especially at lunch, which helps strengthen Mercy Clinic's culture.

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