scholarly journals 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

2007 ◽  
Vol 7 (1) ◽  
Author(s):  
Nicholas M Potisek ◽  
Robb M Malone ◽  
Betsy Bryant Shilliday ◽  
Timothy J Ives ◽  
Paul R Chelminski ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Pain ◽  
Quality Improvement ◽  
Disease Management ◽  
Patient Flow ◽  
Flow Analysis ◽  
Wait Time ◽  
Patient Visit ◽  
Disease Management Programs ◽  
Improve Patient

scholarly journals Attitudes to and experience of disease management programs in primary care—an exploratory survey of general practitioners in Germany

2021 ◽  
Author(s):  
Julian Wangler ◽  
Michael Jansky
Keyword(s):  
Primary Care ◽  
Disease Management ◽  
Patient Care ◽  
General Practitioners ◽  
Linear Regression Analysis ◽  
Chronically Ill ◽  
Disease Management Programs ◽  
Federal States ◽  
Set Up ◽  
Chronically Ill Patients

Summary Background Disease management programs (DMPs) were set up in Germany in 2003 to improve outpatient care of chronically ill patients. The present study looks at the attitudes and experiences of general practitioners (GPs) in relation to DMPs, how they rate them almost 20 years after their introduction and where they see a need for improvement. Methods A total of 1504 GPs in the Federal States of Rhineland Palatinate, Saarland and Hesse were surveyed between December 2019 and March 2020 using a written questionnaire. Results In total, 58% of respondents rate DMPs positively and regard them as making a useful contribution to primary care. The guarantee of regular, structured patient care and greater compliance are regarded as particularly positive aspects. It was also established that diagnostic and therapeutic knowledge was expanded through participation in DMPs. 57% essentially follow the DMP recommendations for (drug) treatment. Despite positive experiences of DMPs in patient care, the GPs surveyed mention various challenges (documentation requirements, frequent changes to the programmes, inflexibility). Univariant linear regression analysis revealed factors influencing the satisfaction with DMPs, such as improvement of compliance and clearly defined procedures in medical care. Conclusion Most of the GPs surveyed consider the combination of continuous patient care and evidence-based diagnosis and treatment to be a great advantage. To better adapt DMPs to the conditions of primary care, it makes sense to simplify the documentation requirements, to regulate cooperation with other healthcare levels more clearly and to give GPs more decision-making flexibility. Increased inclusion of GP experience in the process of developing and refining DMPs can be helpful.

Triage of Rheumatology Referrals Facilitates Wait Time Benchmarks

2016 ◽  
Vol 43 (11) ◽  
pp. 2064-2067 ◽  
Author(s):  
Chandra Farrer ◽  
Liza Abraham ◽  
Dana Jerome ◽  
Jacqueline Hochman ◽  
Natasha Gakhal
Keyword(s):  
Quality Improvement ◽  
Connective Tissue ◽  
Patient Outcomes ◽  
Inflammatory Arthritis ◽  
Wait Time ◽  
Wait Times ◽  
Referral Letter ◽  
Advanced Practice ◽  
Priority Ranking ◽  
Improve Patient

Objective.In 2014 the Canadian Rheumatology Association published wait time benchmarks for inflammatory arthritis (IA) and connective tissue disease (CTD) to improve patient outcomes. This study’s aim was to determine whether centralized triage and the introduction of quality improvement initiatives would facilitate achievement of wait time benchmarks.Methods.Referrals from September to November 2012 were retrospectively triaged by an advanced practice physiotherapist (APP) and compared to referrals triaged by an APP from January to March 2014. Each referral was assigned a priority ranking and categorized into one of 2 groups: suspected IA/CTD, or suspected non-IA/CTD. Time to initial consult and time to notification from receipt of referral were assessed.Results.A total of 558 (n = 227 and n = 331 from 2012 and 2014, respectively) referrals were evaluated with 35 exclusions. In 2012, there were 96 (42.5%) suspected IA/CTD and 124 (54.9%) suspected non-IA/CTD patients at the time of the initial consult. Mean wait times in 2012 for patients suspected to have IA was 33.8 days, 95% CI 27.8–39.8, compared to 37.3 days, 95% CI 32.9–41.7 in suspected non-IA patients. In 2014, there were 131 patients (43%) with suspected IA based on information in the referral letter. Mean wait times in 2014 for patients suspected to have IA was 15.5 days, 95% CI 13.85–17.15, compared to 52.2 days, 95% CI 46.3–58.1 for suspected non-IA patients. Time to notification of appointment improved from 17 days to 4.37 days.Conclusion.Centralized triage of rheumatology referrals and quality improvement initiatives are effective in improving wait times for priority patients as determined by paper referral.

scholarly journals How does clinical space utilisation impact patient flow?

2019 ◽  
Vol 8 (3) ◽  
pp. e000542 ◽  
Author(s):  
Alexandra von Guionneau ◽  
Charlotte M Burford
Keyword(s):  
Quality Improvement ◽  
Waiting Time ◽  
Primary Outcome ◽  
Patient Flow ◽  
Waiting Times ◽  
Wait Time ◽  
Limiting Factor ◽  
Electronic Systems ◽  
Improvement Project ◽  
Medical Wards

BackgroundLong waiting times in accident and emergency (A&E) departments remain one of the largest barriers to the timely assessment of critically unwell patients. In order to reduce the burden on A&Es, some trusts have introduced ambulatory care areas (ACAs) which provide acute assessment for general practitioner referrals. However, ACAs are often based on already busy acute medical wards and the availability of clinical space for clerking patients means that these patients often face long waiting times too. A cheap and sustainable method to reducing waiting times is to evaluate current space utilisation with the view to making use of underutilised workspace. The aim of this quality improvement project was to improve accessibility to pre-existing clinical spaces, and in doing so, reduce waiting times in acute admissions.MethodsData were collected retrospectively from electronic systems and used to establish a baseline wait time from arrival to having blood taken (primary outcome). Quality improvement methods were used to identify potential implementations to reduce waiting time, by increasing access to clinical space, with serial measurements of the primary outcome being used to monitor change.ResultsData were collected over 54 consecutive days. The median wait time increased by 55 min during the project period. However, this difference in waiting time was not deemed significant between the three PDSA cycles (p=0.419, p=0.270 and p=0.350, Mann-Whitney U). Run chart analysis confirmed no significant changes occurred.ConclusionIn acute services, one limiting factor to seeing patients quickly is room availability. Quality improvement projects, such as this, should consider facilitating better use of available space and creating new clinical workspaces. This offers the possibility of reducing waiting times for both staff and patients alike. We recommend future projects focus efforts on integration of their interventions to generate significant improvements.

scholarly journals Primary care physicians’ experience with disease management programs

2001 ◽  
Vol 16 (3) ◽  
pp. 163-167 ◽  
Author(s):  
Alicia Fernandez ◽  
Kevin Grumbach ◽  
Karen Vranizan ◽  
Dennis H. Osmond ◽  
Andrew B. Bindman
Keyword(s):  
Primary Care ◽  
Disease Management ◽  
Primary Care Physicians ◽  
Disease Management Programs

scholarly journals Patient Flow Analysis in General Hospitals: How Clinical Disciplines Affect Outpatient Wait Times

2019 ◽  
Vol 4 (4) ◽  
pp. 128-133 ◽  
Author(s):  
Afsoon Aeenparast ◽  
Faranak Farzadi ◽  
Farzaneh Maftoon ◽  
Hossein Yahyazadeh
Keyword(s):  
Patient Flow ◽  
Flow Analysis ◽  
Wait Time ◽  
Cross Sectional Study ◽  
Outpatient Setting ◽  
Wait Times ◽  
Outpatient Services ◽  
Cross Sectional ◽  
Healthcare Facilities ◽  
Physical Examinations

Background: Overcrowding is an important problem for outpatient services in healthcare facilities. Patient flow analysis (PFA) is a useful method for identifying inefficiencies in and facilitating patient flow. Objective: PFA was used to estimate patient wait time and determine how different clinical disciplines impact wait times in the studied hospital. Methods: This cross-sectional study investigated a study population comprised of outpatients who referred to clinics at a general hospital in Tehran, Iran. A total of 3836 samples were selected from different stations. Nonrandomized quota sampling was used, and data was gathered using workflow checklists, the content validity of which was proven by experts and hospital authorities. SPSS statistical software was used for data analysis. Results: Total patient stay in the outpatient setting was an estimated 77 minutes (without considering para-clinic units and pharmacy). More than 90% of this time was spent waiting. The wait time of patients at the clinic was greater than that at other stations, and it was less at the cash station than at other stations. Wait times varied at different clinics (P value < 0.001) and were correlated with physician delay (P value < 0.001). Conclusion: The most important result of using PFA in the outpatient setting was managing wait times. This study indicated that a considerable amount of a patient’s total stay in the system was related to waiting for physical examinations. This suggests that the first priority in improving the system should be managing patient wait times for physical examinations.

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