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Improving Patient Service Quality in Physical Therapy: A Perspective of Lean

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HCI International 2021 - Late Breaking Papers: HCI Applications in Health, Transport, and Industry (HCII 2021)

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Abstract

The constant growth in the number of patients needing physical therapy has affected service quality and treatment effectiveness. The aim of this study was to address patient demands and service provider limitations through the perspective of lean and explore the possibility of improving the quality of physical therapy service. This study was divided into two stages. First, orthopedics referral patients in the physical therapy department were selected to conduct a customer satisfaction survey (n = 112), and service quality gaps were identified with quantitative and qualitative questions in the survey. The second stage was to develop a semi-structured interview outline based on the aforementioned results, and then to interview seven service providers in the physical therapy department about the limitations and challenges of improving the quality of service. The results showed that, quantitatively, patients’ overall satisfaction was high, but, qualitatively, there were five critical service-quality demands to be improved. Five strategies were proposed for improving service quality based on the service provider’s suggestions and the lean perspectives: 1) Set wayfinding lines from the department of orthopedics to the physical therapy center; 2) Reduce unnecessary motion in the environment and implement 5S; 3) Install a standing chair for patients with fractured foot; 4) Visualize the patient treatment information of the appointment system; 5) Visualize the appointment and attendance status for further improvements in reducing manpower idleness. This study proved that the lean perspective can improve the quality of physical therapy from the patients’ point of view, and at the same time take into account service provider limitations.

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References

  1. Woolf, A.D., Pfleger, B.: Burden of major musculoskeletal conditions. Bull. World Health Organ. 81, 646–656 (2003)

    Google Scholar 

  2. Swinkels, I.C., et al.: An overview of 5 years of patient self-referral for physical therapy in the Netherlands. Phys. Ther. 94(12), 1785–1795 (2014)

    Article  Google Scholar 

  3. Lindsay, R., et al.: Workplace stressors experienced by physiotherapists working in regional public hospitals. Aust. J. Rural Health 16(4), 194–200 (2008)

    Article  Google Scholar 

  4. Deslauriers, S., et al.: Access to publicly funded outpatient physiotherapy services in Quebec: waiting lists and management strategies. Disabil. Rehabil. 39(26), 2648–2656 (2017)

    Article  Google Scholar 

  5. Laliberté, M., et al.: Operationalizing wait lists: Strategies and experiences in three hospital outpatient physiotherapy departments in Montreal. Physiother. Theory Pract. 34(11), 872–881 (2018)

    Article  Google Scholar 

  6. Boak, G., et al.: Quality improvement in physiotherapy services. Int. J. Health Care Qual. Assur. 30(5), 424–435 (2017)

    Article  Google Scholar 

  7. Weitzman, B.C., Kovner, A.R.: Health care delivery in the United States. 5th edn. Springer, Berlin (1995)

    Google Scholar 

  8. Leland, N.E., et al.: Delivering high quality hip fracture rehabilitation: the perspective of occupational and physical therapy practitioners. Disabil. Rehabil. 40(6), 646–654 (2018)

    Article  Google Scholar 

  9. Boak, G., et al.: Distributed leadership, team working and service improvement in healthcare. Leadership in Health Services (2015)

    Google Scholar 

  10. Rutten, G.M., et al.: Evaluation of the theory-based Quality Improvement in Physical Therapy (QUIP) programme: a one-group, pre-test post-test pilot study. BMC Health Serv. Res. 13(1), 194 (2013)

    Article  Google Scholar 

  11. Potter, M., Gordon, S., Hamer, P.: The physiotherapy experience in private practice: the patients’ perspective. Aust. J. Physiother. 49(3), 195–202 (2003)

    Article  Google Scholar 

  12. Del Baño-Aledo, M.E., et al.: Relevant patient perceptions and experiences for evaluating quality of interaction with physiotherapists during outpatient rehabilitation: a qualitative study. Physiotherapy 100(1), 73–79 (2014)

    Article  Google Scholar 

  13. Medina-Mirapeix, F., et al.: Reliability and validity of patient reports for physical therapy quality assessment: an empirical analysis regarding the use of exercises for neck pain in Spain. J. Rehabil. Med. 38(6), 354–359 (2006)

    Article  Google Scholar 

  14. Peter, W., et al.: Healthcare quality indicators for physiotherapy management in hip and knee osteoarthritis and rheumatoid arthritis: a Delphi study. Musculoskelet. Care 14(4), 219–232 (2016)

    Article  Google Scholar 

  15. Mulgan, G.: Design in public and social innovation: what works and what could work better. Retrieved 23(07), 2015 (2014)

    Google Scholar 

  16. Toussaint, J.S., Berry, L.L.: The promise of Lean in health care. In: Mayo Clinic Proceedings. Elsevier (2013)

    Google Scholar 

  17. Shimokawa, K., Fujimoto, T.: The Birth of Lean: Conversations with Taiichi Ohno. Eiji Toyoda, and Other Figures who Shaped Toyota Management, Lean Enterprise Institute, Cambridge (2009)

    Google Scholar 

  18. Harrison, M.I., et al.: Effects of organizational context on Lean implementation in five hospital systems. Health Care Manag. Rev. 41(2), 127–144 (2016)

    Article  Google Scholar 

  19. Carlborg, P., Kindström, D., Kowalkowski, C.: A lean approach for service productivity improvements: synergy or oxymoron? Manag. Serv. Qual.: Int. J. 23(4), 291–304 (2013)

    Article  Google Scholar 

  20. Doğan, N.Ö., Unutulmaz, O.: Lean production in healthcare: a simulation-based value stream mapping in the physical therapy and rehabilitation department of a public hospital. Total Qual. Manag. Bus. Excell. 27(1–2), 64–80 (2014)

    Google Scholar 

  21. Belter, D., et al.: Evaluation of outpatient oncology services using lean methodology. In: Oncology Nursing Forum (2012)

    Google Scholar 

  22. McDermott, A.M., et al.: Restructuring of the Diabetes Day Centre: a pilot lean project in a tertiary referral centre in the West of Ireland. BMJ Qual. Saf. 22(8), 681–688 (2013)

    Article  Google Scholar 

  23. Womack, J.P., Jones, D.T., Roos, D.: The machine that changed the world: the story of lean production--Toyota’s secret weapon in the global car wars that is now revolutionizing world industry. Simon and Schuster (2007)

    Google Scholar 

  24. Ohno, T., Toyota Production System: Beyond Large-Scale Production. CRC Press (1988)

    Google Scholar 

  25. Lin, S.Y., et al.: Use of lean sigma principles in a tertiary care otolaryngology clinic to improve efficiency. Laryngoscope 123(11), 2643–2648 (2013)

    Article  Google Scholar 

  26. Riemen, A.H., Hutchison, J.D.: The multidisciplinary management of hip fractures in older patients. Orthop. Trauma 30(2), 117–122 (2016)

    Article  Google Scholar 

  27. Bekkering, G., et al.: Effect on the process of care of an active strategy to implement clinical guidelines on physiotherapy for low back pain: a cluster randomised controlled trial. BMJ Qual. Saf. 14(2), 107–112 (2005)

    Article  Google Scholar 

  28. Swinkels, I.C., et al.: Physiotherapy management of low back pain: does practice match the Dutch guidelines? Aust. J. Physiother. 51(1), 35–41 (2005)

    Article  MathSciNet  Google Scholar 

  29. Franchignoni, F., et al.: Satisfaction with hospital rehabilitation: is it related to life satisfaction, functional status, age or education? J. Rehabil. Med. 34(3), 105–108 (2002)

    Article  Google Scholar 

  30. Tennakoon, T., de Zoysa, P.: Patient satisfaction with physiotherapy services in an Asian country: a report from Sri Lanka. Hong Kong Physiother. J. 32(2), 79–85 (2014)

    Article  Google Scholar 

  31. Hills, R., Kitchen, S.: Toward a theory of patient satisfaction with physiotherapy: exploring the concept of satisfaction. Physiother. Theory Pract. 23(5), 243–254 (2007)

    Article  Google Scholar 

  32. Peersman, W., et al.: Patients’ priorities regarding outpatient physiotherapy care: a qualitative and quantitative study. Man. Ther. 18(2), 155–164 (2013)

    Article  Google Scholar 

  33. Hush, J.M., Cameron, K., Mackey, M.: Patient satisfaction with musculoskeletal physical therapy care: a systematic review. Phys. Ther. 91(1), 25–36 (2011)

    Article  Google Scholar 

  34. Seferlis, T., et al.: Conservative treatment in patients sick-listed for acute low-back pain: a prospective randomised study with 12 months’ follow-up. Eur. Spine J. 7(6), 461–470 (1998)

    Article  Google Scholar 

  35. Richter, J.P., Muhlestein, D.B.: Patient experience and hospital profitability: is there a link? Health Care Manag. Rev. 42(3), 247–257 (2017)

    Article  Google Scholar 

  36. Ulwick, A.W.: Jobs to Be Done: Theory to Practice. Idea Bite Press (2016)

    Google Scholar 

  37. Dillman, D.A., Smyth, J.D., Melani, L.: Internet, Mail, and Mixed-Mode Surveys: The Tailored Design Method. Wiley, Hoboken (2009)

    Google Scholar 

  38. Goldstein, M.S., Elliott, S.D., Guccione, A.A.: The development of an instrument to measure satisfaction with physical therapy. Phys. Ther. 80(9), 853–863 (2000)

    Article  Google Scholar 

  39. Beattie, P.F., et al.: Patient satisfaction with outpatient physical therapy: instrument validation. Phys. Ther. 82(6), 557–565 (2002)

    Article  Google Scholar 

  40. Medina-Mirapeix, F., et al.: Development and validity of the questionnaire of patients’ experiences in postacute outpatient physical therapy settings. Phys. Ther. 95(5), 767–777 (2015)

    Article  Google Scholar 

  41. CSP. Physiotherapy Outpatient Services Survey 2012 (2013). https://innovations.csp.org.uk/innovation/oldham-first-contact-physiotherapy-service-evaluation-patient-experience. Accessed 20 Feb 2020

  42. LaGanga, L.R.: Lean service operations: reflections and new directions for capacity expansion in outpatient clinics. J. Oper. Manag. 29(5), 422–433 (2011)

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Industrial Design, National Cheng Kung University, Tainan, Taiwan

    Yu-Hsiu Hung, Mei-En Chen & Jia-Bao Liang

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  1. Yu-Hsiu Hung
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  2. Mei-En Chen
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  3. Jia-Bao Liang
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Editor information

Editors and Affiliations

  1. University of Creteand Foundation for Research and Technology – Hellas (FORTH), Heraklion, Crete, Greece

    Constantine Stephanidis

  2. Purdue University, West Lafayette, USA

    Vincent G. Duffy

  3. Ilmenau University of Technology, Ilmenau, Germany

    Heidi Krömker

  4. Missouri University of Science and Technology, Rolla, MO, USA

    Fiona Fui-Hoon Nah

  5. Missouri University of Science and Technology, Rolla, MO, USA

    Keng Siau

  6. University of Central Florida, Orlando, FL, USA

    Gavriel Salvendy

  7. University of West Florida, Pensacola, FL, USA

    June Wei

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Hung, YH., Chen, ME., Liang, JB. (2021). Improving Patient Service Quality in Physical Therapy: A Perspective of Lean. In: Stephanidis, C., et al. HCI International 2021 - Late Breaking Papers: HCI Applications in Health, Transport, and Industry. HCII 2021. Lecture Notes in Computer Science(), vol 13097. Springer, Cham. https://doi.org/10.1007/978-3-030-90966-6_3

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  • DOI: https://doi.org/10.1007/978-3-030-90966-6_3

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