Why ? Office Efficiency is the next level of delay Streamline the work processes Decrease workload Smooth flows Decrease the likelihood of error Create a rational environment for patients, staff and providers Save money
The Link Between Access and Efficiency Efficiency requires reducing delays across the office as well as streamlining work processes This increases throughput More efficient processes and throughput increase capacity
Lead Time Measurement Check inMA to RoomCheck outMD LeavesMD Enters Process Greet Check in/registration Get chart Prepare information Vital signs Interview Prepare information Greet interview Exam Closure Prepare information Closure Over-arching Information transfer Communication, pre, during, post visit Synchronize patient, provider, information, equipment Standardize rooms - means to an end….universal room usage Choreography - co-location, multi-processing staff Batch vs. continuous flow processing Measurement- cycle time/leadtime Audit - sampling
Lead Time Measurement Check in MA to Room MD Enters MD Leaves Check out
Whats a Work Process? A work process is made up of steps, tasks or activities and has a beginning and an end. Key concepts… Input…the materials, equipment, information, people, money or environmental conditions needed to carry out the process. Output…the product or service that is created by the process; that which is handed off to the customer.
Flow Mapping Example… Brushing your teeth Open toothpaste toothpasteWettoothbrushApplypaste to brush to brushBrushteeth Turnofflight Put away pasteandbrush RinsemouthRinsebrush
Flow Mapping Example Pre-appointment registration process 9 a.m. appointment Client enters Reception line 8:45 Client Greeted 8:50 Client Registered 8:53 Demos and Financials confirmed 8:55 Provider greets client and escorts to office. 9:09 Announce Client to Provider 9:08 Client fills out forms, Clerk finds MR Client returns forms 9:00 Forms and Instructions given 8:58 5 min.3 min.2 min. 3 min. 2 min. 8 min.1 min. When did client arrive? What was appointment time? When did appointment start? Why? What could be done differently?
Medical Office Efficiency High Leverage Changes Balance Capacity and Demand Synchronize Patient, Provider, and Information Predict and Anticipate Patients Needs Optimize Rooms and Equipment Manage Constraints
References… Managing the Unexpected, Karl E. Weick and Kathleen M. Sutcliffe, University of Michigan Business School, 2001 Mapping Work Processes, Dianne Galloway, ASQC Quality Press, Milwaukee, Wisconsin Mastering Patient Flow, Elizabeth Woodcock, MGMA Englewood, Colorado, 2000