Natalie Silver1, Randal S Weber2, Miguel Lozano3, Amy Hessel2, Jeremy Meade3, Judy Moore2, Ehab Hanna2, Carol Lewis2. 1. University of Florida, Department of Otolaryngology-Head and Neck Surgery, Gainesville, Florida. 2. Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A. 3. Office of Performance Improvement, University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A.
Abstract
OBJECTIVES: 1) Identify causes of increased patient wait times in a high-volume outpatient cancer clinic; and 2) use quality improvement tools to implement changes to reduce patient wait times. METHODS: Baseline patient wait times for 10 faculty members in the Department of Head and Neck Surgery at the University of Texas MD Anderson Cancer Center (Houston, TX) outpatient head and neck cancer clinic were calculated. Patient workflow and scheduling processes were recorded and analyzed. The faculty with the lowest patient wait times was interviewed, and best practices were identified. Two physicians piloted interventions. Clinic templates were standardized and load-leveled, and the total patients scheduled per hour was based on the physician's calculated capacity per hour. Paired t tests were used to analyze data, and P values <0.05 were considered significant. RESULTS: The baseline patient wait time average was 71 minutes (range 33-122 minutes). Several factors were found to increase patient wait times, including scheduling too many patients in a short time interval at the beginning of clinic hours and exceeding the physician's patient capacity per hour. For physicians implementing changes, the patient wait time was reduced significantly. For physician 3, the average wait time was reduced from 122 minutes to 52 minutes (57% decrease, P < 0.01) For physician 5, the wait time was reduced from an average of 89 minutes to 62 minutes (30% decrease, P < 0.01). CONCLUSION: By applying principles for quality improvement, such as identifying and benchmarking best practices, load-leveling, and standardizing clinic scheduling, patient wait times were significantly reduced. LEVEL OF EVIDENCE: 4 Laryngoscope, 130:E151-E154, 2020.
OBJECTIVES: 1) Identify causes of increased patient wait times in a high-volume outpatientcancer clinic; and 2) use quality improvement tools to implement changes to reduce patient wait times. METHODS: Baseline patient wait times for 10 faculty members in the Department of Head and Neck Surgery at the University of Texas MD Anderson Cancer Center (Houston, TX) outpatient head and neck cancer clinic were calculated. Patient workflow and scheduling processes were recorded and analyzed. The faculty with the lowest patient wait times was interviewed, and best practices were identified. Two physicians piloted interventions. Clinic templates were standardized and load-leveled, and the total patients scheduled per hour was based on the physician's calculated capacity per hour. Paired t tests were used to analyze data, and P values <0.05 were considered significant. RESULTS: The baseline patient wait time average was 71 minutes (range 33-122 minutes). Several factors were found to increase patient wait times, including scheduling too many patients in a short time interval at the beginning of clinic hours and exceeding the physician's patient capacity per hour. For physicians implementing changes, the patient wait time was reduced significantly. For physician 3, the average wait time was reduced from 122 minutes to 52 minutes (57% decrease, P < 0.01) For physician 5, the wait time was reduced from an average of 89 minutes to 62 minutes (30% decrease, P < 0.01). CONCLUSION: By applying principles for quality improvement, such as identifying and benchmarking best practices, load-leveling, and standardizing clinic scheduling, patient wait times were significantly reduced. LEVEL OF EVIDENCE: 4 Laryngoscope, 130:E151-E154, 2020.
Authors: Ashkaun Shaterian; Lohrasb Ross Sayadi; Pauline F Joy Santos; Chloe Krasnoff; Gregory R D Evans; Amber R Leis Journal: J Hand Microsurg Date: 2019-11-02