Jump to content

  • Set Your Location
  • Sign in or Enroll
Set Your LocationCalifornia Pacific Medical Center
  • Find a Doctor
  • Find a Location
  • Donate Now
  • Patient Login
    • Sign In to My Health Online
    • Enroll in My Health Online
    • Learn About My Health Online
    • Open Choose a medical group or hospital
    • Clear my location
Change Location
Sutter Health
  • BOOK APPOINTMENT
  • Book Appointment
  • Profile
Book Appointment
Walk-In Care

In-person care for minor illnesses.

Urgent Care

In-person care for moderate illnesses and injuries.

Video Visits

Virtual care with a Walk-In Care clinician.

Primary Care

Ongoing care and wellness for everyone.

COVID-19

Resources for vaccination and boosters.

Patient Login
  • Sign In to My Health Online
  • Enroll in My Health Online
  • Learn About My Health Online
  • Patients and Visitors

    Patients and Visitors

    Get personalized, coordinated care across Northern California through the Sutter network.

    View Patient Resources
    My Health Online

    Make appointments, message your doctor and more through our patient portal.

    Enroll Now
    • Find a DoctorFind a Doctor
    • Find a LocationFind a Location
    • View All ServicesView All Services
    • Request RecordsRequest Records
    • Pay a BillPay a Bill
    • Check SymptomsCheck Symptoms
    Patient Resources
    • Contact Us
    • Patient and Visitor Information
    • My Health Online Patient Portal
    • Classes and Events
    • Doctor Referrals
    • Health and Wellness
    • COVID-19 Vaccine Resources
    Billing and Insurance
    • Pay a Bill
    • Accepted Health Plans
    • Cost Estimates/Charges
    • Medicare Advantage
    • Sutter Health Plus
  • Treatments and Services

    Treatments and Services

    Access award-winning, comprehensive primary and specialty care for your whole family.

    View All Services
    Schedule a Visit

    Convenient care options for your everyday health needs.

    Book Appointment
    Get Care
    • Primary CarePrimary Care
    • Video VisitsVideo Visits
    • Walk-In CareWalk-In Care
    • Urgent CareUrgent Care
    • Emergency CareEmergency Care
    Featured Services
    • Mental Health
    • Pregnancy and Childbirth
    • Imaging
    • Pediatrics
    • Orthopedics
    • Cancer
    • Heart and Vascular
     
    • Dermatology
    • Physical Therapy
    • Ear, Nose, and Throat (ENT)
    • Labs
    • Urology
    • Neuroscience
    • Women's Health (OB/GYN)
    • View All Services
  • Research and Education

    Research and Education

    Our contributions to medical research and education lead to better healthcare outcomes.

    Research at Sutter
    Graduate Medical Education

    Join our robust training programs led by nationally known healthcare leaders.

    Explore Opportunities
    Research
    • Clinical TrialsClinical Trials
    • Research StudiesResearch Studies
    • PublicationsPublications
    • InvestigatorsInvestigators
    Education
    • Residencies and Fellowships
    • Continuing Medical Education
  • About Sutter

    About Us

    Explore the ways we provide innovative, compassionate care through our network.

    Learn About Sutter Health
    Work at Sutter Health

    Shape the future of healthcare and build your career within our diverse teams.

    Find Jobs
    About Sutter Health
    • About Us
    • Diversity and Inclusion
    • Awards and Honors
    • Leadership
    • Annual Report
    • News and Media
    • Patient Stories
    • Business Programs
    Community
    • Giving
    • Volunteer With Us
    • Community Benefit
    Careers
    • Jobs at Sutter
    • Physician Opportunities
    • Residencies and Fellowships
  • BOOK APPOINTMENTBook Appointment
Logo
  • Patients and Visitors
  • Treatments and Services
  • Research and Education
  • About Sutter
Find a DoctorFind a DoctorFind a LocationFind a LocationContact UsContact UsDonate NowDonate Now
BOOK APPOINTMENT
  • My Health Online Patient LoginMy Health Online Patient Login
  • Set My LocationSet My Location
Logo
  • Find a DoctorFind a Doctor
  • Find a LocationFind a Location
  • View All ServicesView All Services
  • Request RecordsRequest Records
  • Pay a BillPay a Bill
  • Check SymptomsCheck Symptoms
Patient Resources
  • Contact Us
  • Patient and Visitor Information
  • My Health Online Patient Portal
  • Classes and Events
  • Doctor Referrals
  • Health and Wellness
  • COVID-19 Vaccine Resources
Billing and Insurance
  • Pay a Bill
  • Accepted Health Plans
  • Cost Estimates/Charges
  • Medicare Advantage
  • Sutter Health Plus

Patients and Visitors

Get personalized, coordinated care across Northern California through the Sutter network.

View Patient Resources
My Health Online

Make appointments, message your doctor and more through our patient portal.

Enroll Now
Patient
My Health Online

Make appointments, message your doctor and more through our patient portal.

Enroll Now
Logo
Get Care
  • Primary CarePrimary Care
  • Video VisitsVideo Visits
  • Walk-In CareWalk-In Care
  • Urgent CareUrgent Care
  • Emergency CareEmergency Care
Featured Services
  • Mental Health
  • Pregnancy and Childbirth
  • Imaging
  • Pediatrics
  • Orthopedics
  • Cancer
  • Heart and Vascular
  • Dermatology
  • Physical Therapy
  • Ear, Nose, and Throat (ENT)
  • Labs
  • Urology
  • Neuroscience
  • Women's Health (OB/GYN)

Treatments and Services

Access award-winning, comprehensive primary and specialty care for your whole family.

View All Services
Schedule a Visit

Convenient care options for your everyday health needs.

Book Appointment
Logo
Research
  • Clinical TrialClinical Trials
  • Research StudiesResearch Studies
  • PublicationsPublications
  • InvestigatorsInvestigators
Education
  • Residencies and Fellowships
  • Continuing Medical Education

Research and Education

Our contributions to medical research and education lead to better healthcare outcomes.

Research at Sutter
Graduate Medical Education

Join our robust training programs led by nationally known healthcare leaders.

Explore Opportunities
Research
Graduate Medical Education

Join our robust training programs led by nationally known healthcare leaders.

Explore Opportunities
Logo
About Sutter Health
  • About Us
  • Diversity and Inclusion
  • Awards and Honors
  • Leadership
  • Annual Report
  • News and Media
  • Patient Stories
  • Business Programs
Community
  • Giving
  • Volunteer With Us
  • Community Benefit
Careers
  • Jobs at Sutter
  • Physician Opportunities
  • Residencies and Fellowships

About Us

Explore the ways we provide innovative, compassionate care through our network.

Learn About Sutter Health
Work at Sutter Health

Shape the future of healthcare and build your career within our diverse teams.

Find Jobs
Career
Work at Sutter Health

Shape the future of healthcare and build your career within our diverse teams.

Find Jobs
  • Home
  • CPMC
  • Research
  • Primary Care
Content

Implementing lean quality improvement in primary care: impact on efficiency in performing common clinical tasks

Description

Dorothy Y Hung, Quan A Truong, Su-Ying Liang, J Gen Intern Med. doi: 10.1007/s11606-020-06317-9. Online ahead of print., 2020 Nov 24

Investigators

Su-Ying Liang, Ph.D., Research Economist / Faculty

Abstract

Background: Many primary care practices have adopted Lean techniques to reduce the amount of time spent completing routine tasks. Few studies have evaluated both immediate and sustained impacts of Lean to improve this aspect of primary care work efficiency.

Objective: To examine 3-year impacts of Lean implementation on the amount of time taken for physicians to complete common clinical tasks.

Design: Non-randomized stepped wedge with segmented regression and interrupted time series analysis (January 2011-December 2016).

Participants: A total of 317 physician-led teams in 46 primary care departments in a large ambulatory care delivery system.

Intervention: Lean redesign was initiated in one pilot site followed by system-wide spread across all primary care departments. Redesigns included standardization of exam room equipment and supplies, streamlining of call management processes, care team co-location, and team management of the electronic inbox.

Measures: Time-stamped EHR tracking of physicians' completion time for 4 common tasks: (1) office visit documentation and closure of patient charts; (2) telephone call resolution; (3) prescription refill renewal; and (4) response to electronic patient messages.

Results: After Lean implementation, we found decreases in the amount of time to complete: office visit documentation (- 29.2% [95% CI: - 44.2, - 10.1]), telephone resolution (- 22.2% [95% CI: - 38.1, - 2.27]), and renewal of prescription refills (- 2.96% per month [95% CI: - 4.21, - 1.78]). These decreases were sustained over several years. Response time to electronic patient messages did not change significantly.

Conclusions: Lean redesigns led to improvements in timely completion of 3 out of 4 common clinical tasks. Our findings support the use of Lean techniques to engage teams in routine aspects of patient care. More research is warranted to understand the mechanisms by which Lean promotes quality improvement and effectiveness of care team workflows.

Pubmed Abstract

Pubmed AbstractOpens New Window

Associated Topics

  • Lean Management
  • Physician Efficiency
  • Primary Care
  • Primary Care Redesign
  • Primary Care Teams
  • Quality Improvement
  • Workflow / Task Completion

Related Publications

Statin use in older adults for primary cardiovascular disease prevention across a spectrum of cardiovascular risk

Sarraju A, Spencer-Bonilla G, Chung S, Gomez S, Li J, Heidenreich P, Palaniappan L, Rodriguez F.
J Gen Intern Med. doi: 10.1007/s11606-021-07107-7. Online ahead of print.
2021 Sep 10

The migraine signature study: methods and baseline results

Pressman AR, Buse DC, Jacobson AS, Vaidya SJ, Scott AB, Chia VM, Szekely CA, Stewart WF, Lipton RB
Headache. doi: 10.1111/head.14033. Online ahead of print.
2020 Dec 23
The Sutter Health Network of Care
Expertise to fit your needs
Primary Care

Check-ups, screenings and sick visits for adults and children.

Specialty Care

Expertise and advanced technologies in all areas of medicine.

Emergency Care

For serious accidents, injuries and conditions that require immediate medical care.

Urgent Care

After-hours, weekend and holiday services.

Walk-In Care

Convenient walk-in care clinics for your non-urgent health needs.

  • Contact Us
  • Find Doctors
  • Find Locations
  • Book Appointment
  • Request Medical Records
  • Donate Now
Sign in to My Health Online

Billing and Insurance

  • Pay a Bill
  • Accepted Health Plans
  • Estimate Costs
  • Medicare Advantage

About Sutter

  • About Our Network
  • Community Benefit
  • Annual Report
  • News and Media

Our Team

  • For Employees
  • For Medical Professionals
  • For Vendors
  • For Volunteers

Careers

  • Jobs at Sutter
  • Physician Jobs
  • Graduate Medical Education

Copyright © 2023 Sutter Health. All rights reserved. Sutter Health is a registered trademark of Sutter Health ®, Reg. U.S. Patent & Trademark office.

  • ADA Accessibility
  • Privacy
  • Do Not Sell My Personal Information
  • LinkedIn Opens new window
  • YouTube Opens new window
  • Facebook Opens new window
  • Twitter Opens new window
  • Instagram Opens new window
  • Glassdoor Opens new window

Cookie Policy

We use cookies to give you the best possible user experience. By continuing to use the site, you agree to the use of cookies. Privacy Policy Cookie Preferences

Privacy Policy Cookie Preferences