Operational improvements to clinic flow.

253 Background: With expanding clinic volume and future growth potential, we face an issue of limited physical clinic capacity. This has resulted in extended patient wait times, physician idle time, and longer clinics days. Each of these issues adds to both provider and patient dissatisfaction and operational inefficiencies. Methods: Key operational metrics and through put data was analyzed with the oncology team. Agreements and goals for the process improvement were: no provider would be told they could not see a sick patient, patient’s time would be respected and maximize provider productivity. Data demonstrated that the current state would not accommodate future growth. Several operational changes were agreed upon by physician and administrative leadership: level load the days of the week, require several providers to move their clinic days; place structure and real-time discussion into how we manage same day and future “add-on” patients though setting clear expectations around clinician template times; assign a full time staff member to function as a “clinic flow coordinator" to triage same day add-ons, and facilitate provider room assignments, communicate with providers, and identify system or people barriers to clinic flow; provide each of the patients a “restaurant style” pager that will light up when they are ready to be taken to a room, allowing them the freedom to leave the waiting room without fear of missing their appointment time; implement a room-utilization manager software program allowing staff to see and collectively manage real time clinic flow and room utilization. Results: Provider feedback was very positive related to the flow and utilization of clinic rooms. The check-in staff described a less full waiting room even though volumes remained constant. We will monitor patient perception by patient satisfaction scores. Conclusions: To date, much of the results have been anecdotal. In order for these changes to become practice there is a clear need to tie in satisfaction and operational efficiency metrics. There will be ongoing coaching and feedback with providers and staff related to adherence to the new processes. As new providers are added to the practice, we will be very purposeful when adding their creating their templates and adding their clinic days.