What Works: This hospital cut waiting times by 40%

By Medha Basu

Design thinking achieved measurable results.

Queueing is always frustrating, but at hospitals, time becomes even more important.

Singapore’s Tan Tock Seng Hospital prioritised patient time, and cut waiting times by 40% in its outpatient pharmacy over a period of five years. Doctor waiting times, meanwhile, were cut by 7%.

How did they do this? GovInsider explains.

Building more clinics was simply not enough to meet the rapidly growing demand with Singapore’s ageing population. The hospital combined two innovative approaches - lean methodology and design thinking - to redesign the clinics and make processes more productive.

Lean is a management technique adopted from Japanese car factories to find efficiencies and cut wastes in an organisation, while design thinking puts user needs at the centre of how services are made.

Patient-friendly design

The outpatient centre’s floor plan was redesigned to fit in more than double the number of consultation rooms, creating more slots for patients to see doctors.
Services were reorganised in the building to make them easier for patients to locate. “For example, physiotherapy and other therapeutic services are also co-located on the same level for patients’ greater convenience and access,” the team behind the project said.

Coordination between different services was also improved so that patients don't have to make multiple trips within the facility. The clinics are now divided into self-sufficient cells, combining five consultation rooms with a treatment room and a waiting area. Patients now spend 6.7% less time waiting for doctors thanks to this integration.

“Unlike the older clinic layout where patients had to travel from one end to another in the clinic, the new interior layout comprises decentralised common services to ensure patients are served within their zone in the shortest time,” they said.

Self-help and automation

Electronic queue and appointment systems were installed to allow patients to track their queue numbers in real-time. This also allows them to use the same queue number across various clinics within the same day.

“Staff can better monitor and manage patient waiting time via the different coloured prompts. This system has enhanced patient journey and increased work efficiency in the long run,” the team says.

Patients were given tools to manage their services. The self-registration process was simplified and new machines allow patient to take their own blood pressure.
Repetitive tasks in the pharmacy were automated to reduce human errors. A robot now reads electronic prescriptions, and packs the right medicines. As a result, pharmacy technicians have now been redeployed to other tasks, like checking drug supplies at clinics.

People and skills

The project taskforce in itself is an innovation, with members from different disciplines to ensure efficiencies can be squeezed out of every part of the organisation. It includes doctors, nurses, and staff from finance, operations, management information, other health professionals, and senior management.

“Involvement of stakeholders is pivotal to the success,” it say. “The taskforce ensures stakeholders are continuously engaged and work closely together to attain the common vision of delivering best patient care.”

Jobs for frontline staff were redesigned to make them more productive. They have been trained to perform basic procedures, freeing up time for clinical staff. They are also being constantly trained to serve and educate customers, like encouraging them to sign up for government subsidies.

With better design, effective use of technology and the right skills, patients at Tan Tock Seng Hospital spend less time waiting and more time with doctors. Good design is about more than just looks - it is about making every part of a service work better.