The HUS Oral and Maxillofacial Surgery Outpatient Clinic has undergone major changes in recent decades, most prominently the transfer of clinical dentist training to HUS in 2017. About 150 dentistry students, 4,000 patients and 15 physicians and nurses were transferred from the Dental Clinic of the University of Helsinki to the HUS Oral Diseases Teaching and Dental Care unit. The purpose of the change was to improve the students’ teaching and treatment processes and to transfer the clinical teaching of dentistry to the Oral and Maxillofacial Surgery Outpatient Clinic.

The Clinic has occupied premises at several hospitals and units since 2018. Decentralization, added functions and differences in operating cultures brought together by the merger caused extra stress for employees. The Oral Diseases Teaching and Dental Care unit is a busy place, and there is not enough time to do everything. Cooperation was dysfunctional at other units too, and procedures were not uniform.

Bring in Lean

A Lean coach was enlisted to draw up process descriptions of how things were being done and what would be the best way for everyone to do their jobs so as to treat patients appropriately and avoid overloading the teaching dentists, for instance. The project lasted for just under a year and involved introducing weekly whiteboard meetings to sustain and improve the process.

Separate meetings for surgeons

The surgeons at the Oral and Maxillofacial Surgery Outpatient Clinic introduced their own development project with whiteboard meetings.

“It has had the greatest impact. The meetings help us ensure that we’re all on the same page about the current situation and the workload distribution,” says Head Physician Risto Kontio from the Oral and Maxillofacial Surgery Outpatient Clinic.

They are now in better control of the big picture. Both development projects involved taking a broad-based look at the process, from patient arrival to patient departure. The progress of students and their learning and teaching processes up until graduation were also considered in the Clinic’s development project. The surgeons’ project focused on patient wellbeing. The project concluded with successfully established cooperation between surgeons and dentists for the benefit of patients. The nursing personnel also participated in the process review.

“At the next stage of the development project, we will focus on the wellbeing of specializing physicians. We have only just started,” says Kontio.

Wellbeing at work improved

The purpose of Lean development was to ensure that the right people were doing the right things at the right time. Workload was reduced by raising awareness of the big picture and by making processes uniform. It was hoped that this would increase cooperation between students, physicians and nursing personnel and thereby streamline patient care.

Wellbeing at work surveys indicate that the Oral and Maxillofacial Surgery Outpatient Clinic was one of the ten units where the perceived workload had decreased significantly.

“The result is good, better than I expected. Work at the Clinic is now better, and there is less negative feedback from students. Cooperation and decision-making among employees are now better, because we have a clearly defined framework for patient care. The roles of employees in the process are also now better defined,” says Kontio.