1. Improving Patient Access in Family Practice at MetroHealth Medical Center Catalyst Initiative Improvement Project Background Patient survey showed patient dissatisfaction with access MetroHealth leaders received complaints about access Demand exceeded supply. Attending physicians were scheduling 3 months out. National interest in Open Access Aim To make appropriate access available when the patient wants it. To improve patient access To improve patient satisfaction First Improvement Cycle Analyzed Epic access reports and patient satisfaction data Listened to comments made by staff, patients, and providers Eliminated separate “Urgent Care” half-day sessions “Carved Out” urgent care slots (30% per session in each provider’s schedule) Final Improvement Cycle Revised templates created with 50% of slots to be filled within 2 weeks of the appointment. (Access Slots) Revised templates with 10% of slots to be filled within 1 day. (Urgent Slots) Education and feedback with clinical staff and physicians about the new process Information letters to patients Family Practice: How would you rate how long you waited to get an appointment? 43% 31% 26% 47% 32% 21% 51% 34% 15% 0% 10% 20% 30% 40% 50% 60% Excellent + Very GoodGoodFair + Poor 01/01/01 - 05/31/01 N=256 06/01/01 - 01/31/02 N=260 02/01/02 - 10/31/02 N=128 Source: Quality Data Management Patient Satisfaction Data Results Patient Satisfaction Improved Average Days Appt Made to Appt improved from 18 days to 9.9 days Average Days until 4th Available Slot improved from 11 days to 6.7 days How did we measure Success? Gathered Quality Data Management - Patient Satisfaction data: - How would you rate how long you waited to get an appointment? Gathered data from Epic on: - Average Days - Appt Made to Appt - Fourth Available Slot Team Members Shawn Freeman, PSR Leslie Griessing, Cluster Support Assistant Cheryl Jakovcic, RN, Operations Director Laura Lang, Epic Project Leader, Information Services Kathleen Marko, RN Catherine Rutti, MBA, Administrator Mary Jo Slattery, RN, NP, Clinical Coordinator, Nurse Practitioner of Geriatrics Ethel Smith, MD, FPC Physician Stephen Zepp, Catalyst Project Manager Source: Epic Clarity Report: TURNAROUD TIMES Family Practice - Number of Days - 4th Available Slot 16.2 17.5 19.7 9.8 10.2 10.9 9.7 9.6 8.7 7.7 17.7 17.5 17.4 10.8 9.5 19.3 18.8 5.0 10.0 15.0 20.0 25.0 May-01 Jun-01 Jly-01 Aug-01 Oct-01 Nov-01 Dec-01 Jan-02 Feb-02 Mar-02 Apl-02 May-02 Jun-02 Jly-02 Aug-02 Sep-02 Oct-02 Nov-02 Days 9.4 12.1 11.4 12.3 8.7 10.2 11.7 7.4 7.6 7.5 8.78.8 7.0 5.7 5.3 4.4 5.1 12.8 13.4 9.6 10.9 10.2 11.0 0.0 5.0 10.0 15.0 20.0 Jan 5-01 Feb 5-01Mar 5-01 Apl 5-01 May 5-01 Jun 5-01 Jly 5-01 Aug 5-01 Sep 5-01 Oct 5-01 Nov 5-01 Dec 5-01 Jan 5-02 Feb 5-02Mar 5-02 Apl 5-02 May 5-02 Jun 5-02 Jly 5-02 Aug 5-02 Sep 5-02 Oct 5-02 Nov 5-02 Number of Days until 4th Avail Slot Start of New Access System Avg Before = 18.0 Avg After = 9.9 Family Practice - Avg Days Appt Made to Appt. Avg Before = 11.0 Avg After = 6.7 Start of New Access System Source: Epic Report: Schedule Accessibility CATALYST INITIATIVE Quality Resource Unit