The Development of a Diabetic Clinic Service by Applying Lean Concept at Phayakkaphumphisai Hospital, Mahasarakham Province.

Abstract

Introduction : Diabetes is a chronic disease that requires a lifelong ongoing care system. The diabetic clinic service system was found to be congested, delayed and unable to take care of complex problem case. The service recipient is not satisfiled.

Objective : To develop a diabetic clinic service model by applying lean concept and to com pare the results of using the model before and after development.

Methods : for research and development. The sample was 32 patients and 16 providers by simple randomization. During June 2018-February 2019. The study process was divided into three phases: 1) pre-development of the new service model, 2) development of the new service model, 3) application and evaluation of the new model. The instruments consisted : 1) Lean concept; DOWNTIME concept, ECRS tool (Eliminate, Combine, Rearrange, Simplify) 2) Time recording 3) Patients’ satisfaction questionnaires 4) Digital stopwatch, used statistics Paired t-test t0 compare the mean before-after. Present with frequency, percentage, mean, standard deviation.

Result : 1) The steps of working was decreased (from 16 to 7 steps) 2) The average duration of service from 187.75 minutes to 90.25 minutes was statistically significant (P-value <0.001). 3) Overall satisfaction.High-level service recipients 4) Average blood glucose (HbA1C) values decreased from 9.97 t0 9.14

Conclusion : results applying lean concept to diabetic clinic service system development can reduce episode, shorten service time, increase satisfaction and can increase the quality of service.