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| From
the Editor |
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Editorial
A. Abyad (Chief Editor) |
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Original Contribution
Lean processes mapping of diabetic patient
flow in primary healthcare centres in Kuwait
highlights opportunities for fewer patient visits
[Abstract]
[pdf]
Hisham Kelendar, Muhammad Faisal, Mohammed A
Mohammed
DOI: 10.5742MEWFM.2020.93814
The Survey of primary care physicians about
their comprehension of HBA1C , and their understanding
of the common medical conditions that can affect
the accuracy of HBA1C
[Abstract]
[pdf]
Husam Al Saudi , Fazila Khattak
DOI: 10.5742MEWFM.2020.93815
Prevalence of Type 2 Diabetes in a Rural
Population of AbuNakhla, Doha, Qatar
[Abstract]
[pdf]
Mir Saad Hussain , Nusrat Nizamani
DOI: 10.5742MEWFM.2020.93816
Get Acquainted with the Secret "Its
Duration And Not The Type Of Contact That Matters
In COVID-19"
[Abstract]
[pdf]
Hamzullah Khan, Mian Mohammad Naveed, Ghazan
Khan, Mohammad Zahid Khan, Abu Zar, Fazli Bari
DOI: 10.5742MEWFM.2020.93817
The most desired values of high density
lipoproteins in the metabolic syndrome
[Abstract]
[pdf]
Mehmet Rami Helvaci, Abdulrazak Abyad, Lesley
Pocock
DOI: 10.5742MEWFM.2020.93818
Population and Community
Studies
Effects of Touch and Massage Care in Advanced
Alzheimer Patient: A Pilot Case Report
[Abstract]
[pdf]
Emi Miki
DOI: 10.5742MEWFM.2020.93819
Do tourists suffer from depression and
anxiety disorders?
[Abstract]
[pdf]
Yahia Mater AlKhaldi
DOI: 10.5742MEWFM.2020.93820
Identifying depression symptoms among general
population living in conflict zone In Jammu
And Kashmir
[Abstract]
[pdf]
Anood Tariq Wani, Tafazzul Hyder Zaidi
DOI: 10.5742MEWFM.2020.93821
Knowledge, Attitude and Practice of Stethoscope
Disinfection Among Health Care Providers in
Karachi
[Abstract]
[pdf]
Kanwal Jamal, Muhammad Waqaruddin Sheroze, Syed
Tafazzul Hyder Zaidi, Rabisa Batool,
DOI: 10.5742MEWFM.2020.93822
Reviews
World Perspective of Divorce in Selected Countries:
A Sociological Appraisal
[Abstract]
[pdf]
Mohammad Taghi Sheykhi
DOI: 10.5742MEWFM.2020.93823
Parkinson's Disease: An update on Pathophysiology,
Epidemiology, Diagnosis and Management. Part
2 : Etiology and Pathophysiology
[Abstract]
[pdf]
Abdulrazak Abyad
DOI: 10.5742MEWFM.2020.93824
Case Study
Anti-TNF-a drug-induced
lupus: A Case Report
[Abstract]
[pdf]
Abdulaziz Saad Alshahrani
DOI: 10.5742MEWFM.2020.93825
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Chief
Editor -
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| June 2020 - Volume
18, Issue 6 |
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Lean processes mapping of diabetic
patient flow in primary healthcare centres in
Kuwait highlights opportunities for fewer patient
visits
Hisham Kelendar (1)
Muhammad Faisal (2)
Mohammed A Mohammed (3)
(1) Bradford Institute for Health Research,
Faculty of Health Studies, University of Bradford,
Bradford, UK
(2) Senior Research Fellow in Biostatistics,
Bradford Institute for Health Research, Faculty
of Health Studies, University of Bradford, Bradford,
UK
(3) Professor of Healthcare Quality & Effectiveness,
The Strategy Unit, NHS Midlands and Lancashire
Commissioning Support Unit, Faculty of Health
Studies, University of Bradford, Bradford, UK
Corresponding author:
Hisham Kelendar
Faculty of Health Studies, University of Bradford,
Bradford, UK
Email: dr.hisham81@gmail.com
Received: April 2020; Accepted: May 2020; Published:
June 1, 2020. Citation: Hisham Kelendar, Muhammad
Faisal, Mohammed A Mohammed. Lean processes
mapping of diabetic patient flow in primary
healthcare centres in Kuwait highlights opportunities
for fewer patient visits. World Family Medicine.
2020; 18(6): 4-11 DOI: 10.5742MEWFM.2020.93814
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Abstract
Background: Healthcare systems
are facing the ever-present challenges
of increasing demand and limited resources.
To address these concerns, some healthcare
systems have adopted lean methodology
specifically to enhance patient flow by
eliminating waste in hospital settings.
Little is known about the use of lean
in the primary care setting: a setting
that consumes considerable resources and
increasingly handles chronic diseases
such as diabetes.
Aim: To
map the flow of patients with type 2 diabetes
(PWT2D) without any complications in primary
care, identify potential waste and make
recommendations for improvement.
Methodology: We used a descriptive exploratory
approach in the modality of a case study
through semi-structured interviews with
thirteen staff involved in the care of
PWT2D in four Kuwaiti primary healthcare
centres.
Result: PWT2D
typically visit their General Practitioner
(GP) at least every two months for a review
appointment. When a blood test is required
to monitor blood sugar levels, three more
visits are required, involving the blood
test, collection of test results by the
patient and a review of these results
with the GP. Staff acknowledged waste
as non-standardised clinical practice,
delays, waiting times and unnecessary
patient visits. Four potential improvements
were identified which could be consolidated
into a single visit: using point of care
testing, the posting of laboratory results
to GP computer systems, the introduction
of guidelines that standardise the practice
for the patient’s visit and permitting
the GP to prescribe four months of medication.
Conclusion:
The process map of PWT2D has highlighted
waste and improvement suggestions that
may reduce workload, enhance patient satisfaction,
avoid unnecessary visits, enhance the
timeliness of laboratory testing, improve
communication between and across departments
and minimise use of resources without
undermining the quality of care. These
suggestions need to be implemented and
rigorously evaluated.
Key words:
Lean, process mapping, patient flow, value
stream mapping, efficiency, hospital,
healthcare
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