Whether a medical office is an independent clinic or one department in a large hospital, addressing and treating patients in a timely manner is always a priority. Even though lengthy wait times are common, it should be no surprise they also have long been associated with low scores on patient satisfaction surveys. No one likes sitting in a waiting room for an hour while wondering if the person next to them has the sniffles or the plague. Interestingly, patient satisfaction scores are not the only metric negatively affected by long waits.
One study, originally published in the American Journal for Managed Care, indicated that all metrics of patient care are rated negatively on patient surveys when wait times are high. Long wait times have been shown to compromise the quality of patient care, ruin patient trust in their healthcare providers, and cost clinics revenue. Despite this, many medical offices are still consistently beset by overcrowding and long waits.
The best way to improve wait times is to improve patient flow throughout the clinic. But improving patient throughput is no easy task, even for a bunch of med school graduates. Each doctor’s office, hospital, or department is unique. In order to identify slow-downs in patient care and devise solutions, medical clinics need to conduct in-depth research on how their office functions. The Agency for Healthcare Research and Quality actually provides a guide to reduce wait times –including sample templates for drafting improvement strategies– for hospitals where wait times and crowding can be especially bad.
While the guide was originally written to improve patient-flow in large multi-department, multi-disciplinary settings, the same principals can be applied to any medical clinic, big or small, to improve waiting times and overall patient satisfaction scores.
So how do you improve patient flow and throughput?
Form a task-force dedicated to researching, developing and executing a plan. The people you pick for this task-force should be from multiple disciplines or departments, and have strong leadership qualities to help guide the rest of your office as you implement changes. Your team should ideally include someone to act as a day-to-day task-force administrator, a senior office-leader to broadly oversee progress, as well as doctors, nurses and support staff to provide input and act as representatives for all departments in your medical office.
The next step is to collect data on your patient care process that will allow you to determine where slow-downs may be occurring. In order to begin collecting data you need to identify all of the different steps, or ‘data elements’, in your care process. Data elements are all of the points in a patient’s visit where staff has the opportunity to enter information on where the patient is, what is being done at that stage, and how long it takes to complete that step.
These data elements need to be clearly defined and easy for all staff to record. For example, a few good data elements to record would be ‘the time a patient checks in’, ‘the time a patient has their history taken’, as well as the history itself and the reason for the visit.
One of the biggest challenges may be collecting this data efficiently. Data elements can often be recorded in many different locations or files in a clinic, and therefore may be hard to find after the fact. You might need to implement a new reporting system that co-ordinates between different departments to collect all the data points in one place. This may seem like herding cats at the start, but you’ll find it makes things much easier in the long run.
In order to develop an effective plan, your task-force will need to do a few things: First, you’ll need to use the data you’ve collected to determine what’s causing slow-downs in your office. What steps, or ‘data elements’, in your patient care process are taking an unusually long time?
Once you’ve identified the problem, start researching possible solutions. Look online and in industry publications to see if other clinics and organizations have experienced similar problems. See what steps they took to improve, and how successful their strategies were.
"develop a strategy you can execute with the resources at hand"
Lastly, consider what resources you can realistically dedicate to solving the problem. A well-funded hospital may be able to throw money at the problem and implement an expensive, ambitious strategy that a small neighborhood clinic just can’t copy. Determine the number of staff and the amount of money you can afford to dedicate to solving your delays. It could be stacks of money and a fully staffed new department, or just the change you scrape together from under your waiting room couch cushions and Bev from reception. Then figure out what reasonable goals for improvement you can set, and develop a strategy you can execute with the resources at hand.
Remember, when setting your goals they should be specific and measurable. Such as “New patients will be escorted to an exam room to have their history taken within 10 minutes of checking in at reception.” Also make sure to solicit and listen to your staff’s feedback and opinions on your strategies, goals, and execution. There will always be some initial groaning and dragging-of-feet whenever big changes are made to work-flow, but your staff will have valuable insight on how your strategies can be improved or better implemented on the day-to-day level.