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Introduction to 5 Productive work flows

Up to 5. Productive work flows
June 15. 2016
Robert Varnam

What is this?

This is about introducing new ways of working which enable staff to work smarter, not just harder. These can reduce wasted time, reduce queues, ensure more problems are dealt with first time and that uncomplicated follow-ups are less reliant on GPs consultations.

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Benefits for patients

  • Improves appointment availability and customer service.
  • Reduces errors

Benefits for practice

  • Frees time for staff throughout the practice. 
  • Reduces errors and rework. 
  • Improves appointment availability and patient experience.


5.1 Match capacity with demand

Appointment systems and staff rotas are designed in order to ensure sufficient capacity is available to match patterns of demand as they vary through the week and the year. This requires an ongoing system of measuring demand and adjusting capacity accordingly. It may also involve scheduling routine work (eg annual reviews and clinical audit) for less busy times of the year. The benefits are a reduction in delays for appointments, less stress for staff and patients, and better access.

5.2 Efficient processes

The application of Lean principles to measure, understand and improve common processes in the practice, in order to reduce waste and errors. Typical targets include clinical follow-up protocols, processing of letters and test results, requests from patients, staff messages and team decision making. Staff themselves often have a wealth of ideas about ways in which processes could be improved to release time. Practices who take a systematic approach to identifying and testing these generally find that this improves care for patients as well as freeing staff time for other things. The use of pre-prepared plans for managing common simple follow-up processes can improve their reliability and efficiency, freeing GP time. Common examples include management of hypertension, monitoring of tests after the initiation of new medication, and adjustment of medication doses to reach a target.

5.3 Productive environment

The physical layout within the practice is assessed for its effect on staff's productivity, and improvements are introduced which reduce wasted time. The Lean technique of 5S is the best known approach for doing this. Additionally, work can be undertaken to ensure that staff can access information needed to support their work quickly. This reduces time spent searching for information and can improve patient safety as well.


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