Reducing Patient Waiting Time for Better Patient Outcomes

Reducing Patient Waiting Time for Better Patient Outcomes
Step 1
Most healthcare institutions start their day with the intention of perfectly managing their time schedules. While the expected outcome is excellent patient outcome many practices often end up bringing in more patients into a schedule that is already overloaded hence requiring more time to attend to the scheduled patients (Capko, 2015). The outcome of the busy schedules is inefficiency, bottlenecks, frustration, and more waiting time for the patients. Patients are forced to spend more time in the exam room or reception area waiting for an opportunity to be attended to (Capko, 2015). For the patient things appear to be moving in slow motion.
In order to overcome the scheduling problems it is important to address the foundation of this patient scheduling problems. It may seem easy but it is more complex than many would think. It takes a lot of dedication and time to enhance the patient scheduling program and as many practices are structured it seems that no one has the time to do it. If the problem is not properly clarified and identified then it is quite difficult to come up with plausible solutions likely to enhance efficiency and remove the bottlenecks while facilitating better management of the day (Capko, 2015).
The good news is that there are better tools and innovations that can help the healthcare practice understand the patient flow and scheduling problems (Capko, 2015). A good number of scheduling systems have an ability to report problems and accurately track the patient throughout the process including the time of their appointment, time of arrival, the time to be in a specific room, seen by the physician, and the time of completion of a patient visit. By evaluating the data it is possible to gather significant information for the identification of trends and foundation of the patient flow and scheduling problems. The information gathered is fundamental in evaluating specific circumstances and making a determination on the causes of the workflow and bottleneck problems in the practice (Capko, 2015).
Step 2
The anticipated patient scheduling changes will take place under the context of the entire healthcare practice. The scheduling changes will start from the reception, to the examination room, to the physician’s room, and all through the entire practice facility. The objective is to align the entire patient scheduling system with an objective of making sure that every patient is attended to immediately upon their arrival without any delays that might occasion irreparable damages. The intended changes will affect all the healthcare workers including the nurses, physicians, administrators, and all the amenities.
The intended changes will affect the entire practice and the personnel in it including the patient, the administrators, physicians, and the nurses. The intended changes might mean increasing the number of physicians, nurses, examination rooms, facility reception etc. The anticipated changes will have to be approved by the finance department, the hospital executive management, and the nursing manager. The proposed changes may require financial investment and top tier approval from the hospital management.
Step 3
Literature Review- current best practices in Healthcare Scheduling
Brandenburg et al. (2018) in evaluating the best practices in scheduling of healthcare examined how CEO’s in leading health systems in the United States handled the difficult issue concerning the waiting time through the healthcare continuum. The researchers reviewed crucial forces that shaped wait times in the healthcare environment and the evolution of tools and techniques from several industries in the quest to enhance healthcare access and drive towards a healthcare model that was person centered (Brandenburg et al., 2018). Although organizations have differing populations served, institutional constructs, and sizes, Brandenburg et al. (2018) acknowledged that improved scheduling and access necessitated transformation at systems level and the transformation had the potential to unearth previous unidentified resources and help improve all the aspects of healthcare delivery. Brandenburg et al. (2018) provide some examples that highlight the principles of system wide view application, disciplined methodology application for system design (like six sigma, lean, prediction tools, and modeling), and the people respect as a foundation.
Haraden and Resar (2004) assert that cancellations, delays and waits are common phenomena in healthcare and that the providers and patients assume that these waits cannot be avoided. Hospitals often add resources to deal with the delays like adding more debs, buildings, and staff. With more staff and more constructions the delays and inefficiencies only increased in the healthcare system (Haraden & Resar, 2004). Haraden and Resar (2004) found that delays are not caused by resource problems but they are flow problems. Research in 60 United Kingdom and United States hospitals sought to investigate what influenced their timely and smooth patient flow through each of the departments for a better implementable method of flow improvement. The focus was found to be focus on elective surgery flow, alleviation of wait time for inpatient admission in the emergency departments, efficient and timely patient transfer from the ICU to the surgical or medical units, and enhanced flow of patients from inpatient to long-term facilities of care.
Zhao et al. (2017) conducted a research on barriers and benefits of implementing the web based system of healthcare appointments. The findings indicated that most practices that showed positive change in their metrics after implementation of the web based scheduling method. There was reduction in staff labor, alleviated no-sow rate, minimized waiting time, and enhanced satisfaction. The barriers to this system were safety, integrity, cost and flexibility. The main influencers to the reluctance to switch to the web based scheduling system were patient experiences with the internet and computers and the difference in the preferences of communication.
Step 4
The implementation plan will entail establishment of a baseline to help determine what is proper schedule and the point at which a delay is assumed to have taken place. The delay time will be 15 minutes allowance from the time the patient is scheduled for appointment and the time the physician gets to the examination room. Below is the proposed framework for reduced waiting time.
· Patient information will be gathered prior to the appointment
· Documentation will be delegated to the Electronic Health Records department
· Documentation will be handled by trained staff through the HER system
· Secure messaging will be used to communicate with patients.
· A clear policy will be used for late arrivals and no-sows. Late patients will be rescheduled and a late fee will be charged to repeat offenders.
· Bottlenecks will be identified through a survey
· The plan will include a mobile queuing tool where patients can virtually get into a waiting line that gives them an update of their position.
· Tele-health solutions for streamlining the gathering of records, late arrivals, and no-shows will be used.
This implementation plan will help cut the patient visit time by half and offer more convenience to patients, nurses, physicians and other personnel. With lesser time spent in the waiting rooms time wastage for the patient and facility will be greatly enhanced.



References
Brandenburg, L., Steele, G., Gabow, P., Tyson, B. J., & Toussaint, J. (2018). Innovation and Best Practices in Health Care Scheduling. NAM Perspectives, 5(2). https://doi.org/10.31478/201502g
Capko, J. (2015). To Improve Practice Work Flow, Tackle Patient Scheduling, Modern Medicine Network. Retrieved 8 March, 2019 from https://www.physicianspractice.com/scheduling/improve-practice-work-flow-tackle- patient-scheduling
Haraden, C., & Resar, R. (2004). Patient flow in hospitals: understanding and controlling it better. Frontiers of Health Services Management, 20(4), 3–15. https://doi.org/10.1097/01974520-200404000-00002
Iafolla, T. (2019). 8 ways to reduce patient wait times, eVisit. Retrieved 8 March, 2019 from https://blog.evisit.com/reduce-patient-wait-times
Zhao, P., Yoo, I., Lavoie, J., Lavoie, B. J., & Simoes, E. (2017, April 1). Web-based medical appointment systems: A systematic review. Journal of Medical Internet Research. Journal of Medical Internet Research. https://doi.org/10.2196/jmir.6747