Journal of the Dermatology Nurses' Association

April 2009, Volume 1 Number 2 , p 144 - 144 [FREE]


  • Jenny Kevric LPN
  • Cheryl Reser LPN
  • Susan Rouleau LPN


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We used the tools of process improvement and Lean Thinking to understand our current process of Mohs surgery and to identify areas for improvement.



The methods used to improve patient flow were Six Sigma tools learned from an in-house quality improvement training course. We used these tools to define, measure, analyze, improve, and control the process.



Several time studies identified that our patients spend long periods of time in the department mainly due to wait times between the different stages of Mohs surgery. We learned that when patients are batched together to begin their surgeries, they have to wait for the surgeon. This results in wasted time of the staff and can lead to patient dissatisfaction.



We are implementing a new scheduling template where the focus is on one patient at a time. This will enable a Mohs surgery to be done in a more timely fashion, resulting in less waiting time for the patient. The streamlined work flow keeps patients moving through the surgical area, maximizes the surgical calendar, and gives us the opportunity to increase the number of patients.



As patients move through the Mohs surgical area more efficiently, the nursing staff spend less time waiting with their patients for the surgeon. This newfound time can be used in different aspects of their multifaceted role.