title: Decreasing the dispatch time of medical reports sent from hospital to primary care with Lean Six Sigma.
abstract: OBJECTIVE
  Timely communication is important to ensure high-quality health care. To facilitate this, the Gastro Intestinal Oncology Center Amsterdam (GIOCA) stipulated to dispatch medical reports on the day of the patient's visit. However, with the increasing number of patients, administrative processes at GIOCA were under pressure, and this standard was not met for the majority of patients. The aim and objective of this study was to dispatch 90% of medical reports on the day of the patient's visit by improving the logistic process.
  
  
  METHODS
  To assess the main causes for a prolonged dispatch time and to design improvements actions, the roadmap offered by Lean Six Sigma (LSS) was used, consisting of five phases: Define, Measure, Analyze, Improve and Control (DMAIC roadmap).
  
  
  RESULTS
  Initially, 12.3% of the reports were dispatched on the day of the patient's visit. Three causes for a prolonged dispatch time were identified: (1) determining which doctors involved with treatment would compose the report; (2) the reports composed by a senior resident had to be reviewed by a medical specialist; and (3) a medical specialist had to authorize the administration to dispatch the reports. To circumvent these causes, a digital form was implemented in the electronic medical record that could be completed during the multidisciplinary team meeting. After implementation, 90.6% of the reports were dispatched on the day of the visit.
  
  
  CONCLUSIONS
  The dispatch time of reports sent from hospital to primary care can be significantly reduced using Lean Six Sigma, improving the communication between hospital and primary care.
authors: Departments of Gastroenterology & Hepatology, Academic Medical Center (AMC), Amsterdam, The Netherlands.
authors: Yara L
authors: YL
authors: Basta
authors: IBIS UvA, Department of Operations Management, Amsterdam Business School, University of Amsterdam, Amsterdam, The Netherlands.
authors: Inez M
authors: IM
authors: Zwetsloot
authors: Department of Surgery, Gelre Ziekenhuis, Apeldoorn, The Netherlands.
authors: Jean H G
authors: JH
authors: Klinkenbijl
authors: Gastro Intestinal Oncology Center, Academic Medical Center (AMC), Amsterdam, The Netherlands.
authors: Thomas
authors: T
authors: Rohof
authors: ING Domestic Bank, Amsterdam, The Netherlands.
authors: Mathijs M C
authors: MM
authors: Monster
authors: Department of Surgery, Academic Medical Center (AMC), Amsterdam, The Netherlands.
authors: Paul
authors: P
authors: Fockens
authors: Department of Surgery, Academic Medical Center (AMC), Amsterdam, The Netherlands. k.m.tytgat@amc.nl.
authors: Kristien M A J
authors: KM
authors: Tytgat
mesh_terms: D000368:Aged; D017598:Efficiency, Organizational; D005260:Female; D006761:Hospitals; D006801:Humans; D033181:Information Dissemination; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011320:Primary Health Care; D058996:Quality Improvement; D011787:Quality of Health Care; D013997:Time Factors; D017749:Total Quality Management / Q000379:methods*
keywords: Lean Six Sigma; efficiency of care; hospital care; primary care; quality improvement; timely communication