Practice Pearls

Using Lean Six Sigma’s “define-measure-analyze-improve-control” framework, our urgent care clinic examined our patient intake workflow to identify inefficiencies and implement practical, sustainable changes. We shifted to a room-first model, meaning staff members take patients directly to an exam room upon arrival (or as soon as one becomes available), with all patient tasks — vitals, forms, etc. — completed in-room instead of in separate areas. In addition to eliminating excess movement, this work-flow reduces interruptions and improves the consistency of room turnover.

Staff training ensured everyone had a clear understanding of their roles in the new process. We created a real-time dashboard to provide ongoing visibility into cycle times and patient flow, which allows the care team to respond proactively to delays. Since implementing this workflow, patients have reported smoother visits and staff have noted a decrease in workflow interruptions. The clinic operates more predictably even during peak hours.

Managing clinician time-off requests can be burdensome and error-prone. Our clinic was plagued with absence requests, which became more challenging as our clinic grew. We transitioned to a cloud-based, centralized system in the form of a SharePoint spreadsheet to stay organized.

There can be a learning curve with any new tool, but the payoff is significant when it is up and running. Every clinician has access to add or edit entries. The spreadsheet includes the requester (physician, administrator on behalf of a clinician who has called in sick, etc.), request date, time-off start and end dates, type of leave (PTO, CME, planned sick day, work meeting, jury duty, etc.), and comments. The tool automatically emails updates to relevant individuals. Columns for status (pending, approved, or denied) and approver are filled in by managers. When time off is approved, managers assign a clinician to cover the absentee’s in-basket tasks and note this in the spreadsheet. Color-coding and filtering highlight past dates, current absences, and holiday requests. Emails are still involved, but the spreadsheet is the central hub and accessible to everyone.