Quality improvement approach to reduce patient cycle time at a student-run free healthcare clinical network.

IF 1.3 Q4 HEALTH CARE SCIENCES & SERVICES BMJ Open Quality Pub Date : 2024-10-02 DOI:10.1136/bmjoq-2024-002951
René Marcella Kronlage, Amy S Stanley, Miranda J Reid, William Hudson Shaw, Cara E House, Michele N Lossius, Artenisa Kulla, Kendyll Coxen, Phillip M Mackie, Carolyn K Holland
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Abstract

Background: The University of Florida (UF) Equal Access Clinic Network (EACN) is the largest student-run free healthcare clinic network in Florida. The UF EACN serves those who are underinsured or uninsured in Alachua County and its surrounding area. Nationally, average total clinic time per medical visit has been established to be 84 min.

Problem: Before this project, average patient cycle time at the UF EACN was 125.3 min, and there was no established quality improvement (QI) team to implement changes to address inefficiencies.

Methods: This was a prospective QI study that recorded patient cycle times for patients who received healthcare at any of the four primary care free clinics across the UF EACN from 5 July 2022 to 6 April 2023.

Interventions: Eighteen Plan-Do-Study-Act cycles were tailored to each of the four primary care clinic's needs with a focus on reducing patient cycle time by addressing the following identified problems: prolonged intake process, translation services, limited numbers of volunteers, and other inefficiencies and bottlenecks in workflow.

Results: The median patient cycle time at the EACN shifted from 125.3 min to 112.7 min over a nine month period. This drop of 12.6 min meant patients saw a 10.1% reduction in patient cycle time across the EACN.

Conclusion: Underserved patients at EACN are experiencing increased value by having shorter patient cycle times.

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在学生运营的免费医疗保健临床网络中,采用质量改进方法缩短病人就诊周期。
背景:佛罗里达大学平等机会诊所网络(EACN)是佛罗里达州最大的由学生运营的免费医疗保健诊所网络。佛罗里达大学平等机会诊所网络为阿拉瓜县及其周边地区保险不足或无保险的人群提供服务。在全国范围内,每次就诊的平均总门诊时间为 84 分钟。问题:在开展该项目之前,佛罗里达大学 EACN 的患者平均就诊周期为 125.3 分钟,而且没有一个成熟的质量改进(QI)团队来实施变革,以解决效率低下的问题:这是一项前瞻性 QI 研究,记录了 2022 年 7 月 5 日至 2023 年 4 月 6 日期间在整个 UF EACN 的四个初级保健免费诊所中任何一个诊所接受医疗服务的病人的周期时间:18个 "计划-实施-研究-行动 "周期是根据四个初级保健诊所的需求量身定制的,重点是通过解决以下已发现的问题来缩短患者就诊周期:接诊流程过长、翻译服务、志愿者人数有限以及工作流程中的其他低效和瓶颈:结果:在九个月的时间里,EACN 患者就诊周期的中位数从 125.3 分钟缩短至 112.7 分钟。这意味着整个 EACN 的病人就诊周期缩短了 10.1%:结论:EACN 的病人就诊周期缩短,为得不到服务的病人带来了更多价值。
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来源期刊
BMJ Open Quality
BMJ Open Quality Nursing-Leadership and Management
CiteScore
2.20
自引率
0.00%
发文量
226
审稿时长
20 weeks
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