Use of patient flow analysis to improve patient visit efficiency by decreasing wait time in a primary care-based disease management programs for anticoagulation and chronic pain: a quality improvement study.
BACKGROUND
Patients with chronic conditions require frequent care visits. Problems can arise during several parts of the patient visit that decrease efficiency, making it difficult to effectively care for high volumes of patients. The purpose of the study is to test a method to improve patient visit efficiency.


METHODS
We used Patient Flow Analysis to identify inefficiencies in the patient visit, suggest areas for improvement, and test the effectiveness of clinic interventions.


RESULTS
At baseline, the mean visit time for 93 anticoagulation clinic patient visits was 84 minutes (+/- 50 minutes) and the mean visit time for 25 chronic pain clinic patient visits was 65 minutes (+/- 21 minutes). Based on these data, we identified specific areas of inefficiency and developed interventions to decrease the mean time of the patient visit. After interventions, follow-up data found the mean visit time was reduced to 59 minutes (+/-25 minutes) for the anticoagulation clinic, a time decrease of 25 minutes (t-test 39%; p < 0.001). Mean visit time for the chronic pain clinic was reduced to 43 minutes (+/- 14 minutes) a time decrease of 22 minutes (t-test 34 %; p < 0.001).


CONCLUSIONS
Patient Flow Analysis is an effective technique to identify inefficiencies in the patient visit and efficiently collect patient flow data. Once inefficiencies are identified they can be improved through brief interventions.
Potisek
Nicholas M
NM
Malone
Robb M
RM
Shilliday
Betsy Bryant
BB
Ives
Timothy J
TJ
Chelminski
Paul R
PR
DeWalt
Darren A
DA
Pignone
Michael P
MP
D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use*; D002908:Chronic Disease; D019468:Disease Management; D017598:Efficiency, Organizational / Q000592:standards / Q000706:statistics & numerical data*; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007388:Internal Medicine / Q000458:organization & administration*; D008297:Male; D008875:Middle Aged; D009657:North Carolina; D009819:Office Visits / Q000706:statistics & numerical data; D010044:Outpatient Clinics, Hospital / Q000458:organization & administration* / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000458:organization & administration* / Q000706:statistics & numerical data; D017064:Process Assessment, Health Care / Q000379:methods*; D013996:Time and Motion Studies; D017749:Total Quality Management / Q000379:methods
D000925:Anticoagulants