QSI - Nash

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• Last Updated on Tuesday, 23 April 2013 15:43

NAME OF HEALTH DEPARTMENT: Nash County

PROJECT TITLE: QSI - Nash

PROJECT TEAM LEAD AND CONTACT INFO:         
Patricia Artis
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Project Overview

Project Aim:
We aim to improve clinic flow and overall wait time for clients by decreasing or eliminating non-value added activities within the process. This is important because increasing clinic flow and efficiency will allow increased client clinical services satisfaction, which will enhance the overall clinic experience for clients. This will increase the number of patients we are able to see as well as client show rates.

Goals:

• Decrease cycle time by 25% from 120 minutes to 90 minutes
• Increase client satisfaction with clinical services from 62% to 85%
• Increase staff satisfaction with process from 43% to 70%
• Increase show rates for clinics from 65% to 85% (overall expected outcome)
• Increase number of clients seen in clinics (aggregate) from 72% to 85%

Project timeframe:
Goal to complete this QI project by June 2012

How was the need for the project determined?
Clinic flow and efficiency are always a concern. We noticed clinic staff were not getting off on time due to clinic running behind which costs money and leads to decreased patient satisfaction and staff satisfaction. Patients were getting upset because of long wait times and many pts were no showing. No show rates negatively impact revenue.  To us finding a way to make clinic run on time and run more efficiently was very important for many reasons including staff being happy, pts being happy and increasing revenue for our county.

Does this quality improvement project link to accreditation?
Yes, streamlining delivery of clinical services helps to increase efficient use of resources and staff to reach more people which can impact outcomes. We strive to promote clinic efficiency in work flow and demand/capacity. There is an increased demand for organizations to perform better and improve health outcomes with less funding which aligns with the goals of accreditation.

Areas for Improvement and Change Ideas Implemented

Improvement 1
Building layout and lab

• To decrease the number of steps patients have to take during visits we rearranged order of tasks in process to vitals, bathroom, lab, interview, and exam. Nurse may call pt for interview if lab unavailable first.

Improvement 2
Weighing and blood pressure stations for maternity clients

• We now have 2 weight and BP stations in both offices. Patients are able to be weighed and sent to lab quicker.

Improvement 3
Rearrangement of lobby seating

• To improve the atmosphere of the waiting area, chairs are grouped in clusters to encourage patient conversation and interaction with each other. We have a children’s area with table, chairs, and books. The television broadcasts educational material.

Improvement 4
Clinical staff reporting to the wrong office

• Huddles are MANDATORY for Personal Care and Management Support staff. This has decreased the number of times staff reports to wrong office/clinics, and staff is here on time.  Clinic starting on time gives a better chance for clinic ending on time.

Results

Overall Improvements

• Increase in staff satisfaction, (survey results)
• Decrease in comp time ( graph)
• Increase in Show rate to 77%

Lessons Learned

• Layout of building is a barrier to some changes.
• Appointment System (Open Access) needs to be revamped