78th MDG continuously improves processes with AFSO21 Published Dec. 7, 2007 By Lisa Mathews 78th ABW/XP Robins AFB, Ga. -- Ensuring patients receive the best possible care in the most timely manner is a priority for the 78th Medical Group at Robins. The group's commander, Col. Jim McClain, said the concept of process improvement is an important part of the reason the group can efficiently and effectively accomplish its mission. "In the medical business we, like any organization, face challenges with manpower, challenges with money and we support a very diverse population," he said. "The medical business itself is a very complex process. Most patients don't see that process; they just see the point-of-contact with the physician, and they don't see all the other dynamics behind it." Colonel McClain credits Air Force Smart Operations for the 21st Century and Lean initiatives for the group's successes to date in eliminating waste in processes and he said the group strategically plans events each year to continue improving. Maj. (Dr.) Chrystal Henderson, chief of the medical staff, and Katty Adkins, manager for quality, patient safety and performance improvement, are two champions of the implementation of AFSO21 initiatives, according to the colonel. He said the two have played important roles over the last couple of years with multiple AFSO21 events for improvements in areas such as access to care, optimizing annual health care assessments, medical evaluation board processes, appointment scheduling and standard work in healthcare operations. "We've just recently completed our third AFSO21 look at our preventative health assessment and our annual health assessment process," Colonel McClain said. "That's key to the AFSO21 concept - it's not just a one-time thing; you're always looking for ways to improve and make it better and better." An event on health care operations accomplished just that. "The healthcare optimization event decreased the overall number of steps taken by the clinic personnel during each patient's visit," said Major Henderson. "By decreasing the number of steps overall, the transit time for patients within the clinic during their visit was decreased 50 percent." An Air Force Materiel Command-led effort is ongoing to apply AFSO21 to medical operations throughout the command, Colonel McClain said. "AFMC is the Air Force medical service AFSO21 champion and Robins Air Force Base, specifically the 78th Med Group, has been identified as the champion for expeditionary health processes," the colonel said. "So anything health related to getting people out the door to support our military operations, we are the champion for AFMC for that process." From a recent pre-deployment rapid improvement event, they estimate a 50-percent reduction of time a patient will need to spend in the medical group to ensure all of their healthcare needs are met prior to deployment. The colonel said that, eventually, the gains realized by AFMC could be used throughout the entire Air Force. The group not only works to improve processes for deploying military, they also look for ways to improve healthcare services to all patients which include military, retired military and dependents. The group has developed the one-stop shop method. For example, the PHA process used to include multiple visits to the clinic. Now, for most cases, patients are in and out in one visit and the time for that visit has been reduced from several hours to, on the average, less than one. Patients now are seen in one room and the healthcare providers come to the patient rather than the patient having to move throughout the clinic to different locations. "The medical management event integrated the different areas involved in the care for complicated patients under one umbrella which has enhanced continuity of care for those patients and decreased the likelihood of parts of their care falling through the cracks," said Major Henderson. Major Henderson added that additional events, such as 6S - which stands for sort, straighten, scrub, safety, standardize and sustain - also take place during the year. The group recently was the winner in the 78th Air Base Wing's 6S competition. Through the group's 6S event in their logistics area they accomplished a 698-percent increase in available floor space and realized a savings of $17,000 when they were able to cancel an order for additional shelves. The group has a dedicated core team that annually plans 10 to 12 events. Mrs. Adkins and Major Henderson are both members of this core team. "Annually, we strategically plan events so that we have a game plan pertaining to what we want to focus on," Colonel McClain explained. "We generally try to focus on the things that will bring us the greatest value and the things that have the most importance to our patients."