Improvement Project

Report Out

Newson Twosome

ACA Central

April 8, 2016

Define-Problem Statement

Patient satisfaction for access is low due to

unavailability of appointments and

difficulty in reaching the office.

Rooms are not organized and equipment is

not always readily available which

disrupts flow and causes inefficiencies.

Daily

Supply

• Daily number of appointments available in physician’s schedule.

Daily Demand

• Daily number of appointments request for any given day

• external demand – generated by clients

• internal demand – generated by provider (i.e., F/U appointments)

Daily Activity

• Actual number of appointments accommodated

• pre-booked appointments

• same day appointments

TNAA

• Time to third next available appointment (TNAA) – Standard measure of wait time.

Measure

Analyze

• Start of the day – already over booked

• Internal demand - 25%

• External demand –Telephone 56% of all calls are seeking

appointments (18% booked same day and 72% future):

• 46% of calls are for reasons other than appointments.

• 19 day wait for an appointment.

Analyze

Tues. May 19

Wed. May 20

Thurs. May 21

Mon. May 25

Tues. May 26

Wed. May 27

Tues. June 23

Wed. June24

Thurs. June 25

Mon. June 29

Tues. June 30

Booked Office Visits 8 15 11 19 9 17 6 18 15 26 9

Same Day Office Visits 2 0 2 3 0 0 0 1 2 2 0

Total Visits/Day 10 15 13 22 9 17 6 19 17 28 9

Average 15 15 15 15 15 15 15 15 15 15 15

Median 15 15 15 15 15 15 15 15 15 15 15

0

5

10

15

20

25

30

Axi

s Ti

tle

Dr Newson Daily Activity

10 Days Between May 19-June 30, 2015

Analyze

6/20/2016

Tues. May 19

Wed. May 20

Thurs. May 21

Mon. May 25

Tues. May 26

Wed. May 27

Tues. June 23

Wed. June24

Thur. June 25

Mon. June 29

Tues. June 30

Total External Demand 6 3 7 10 1 7 3 5 12 9 4

Internal Demand (Follow ups) 3 5 3 3 0 0 2 4 1 4 0

0

2

4

6

8

10

12

14

Dr Newson- Daily Demand for Appointments (Future) 10 Days Between May 19-June 30, 2015

Total External Demand

Internal Demand (Follow ups)

6/20/2016

Tues. May 19

Wed. May 20

Thurs. May 21

Mon. May 25

Tues. May 26

Wed. May 27

Tues. June 23

Wed June24

Thurs. June 25

Mon. June 29

Tues. June 30

Average Median

Daily Supply 7 16 9 16 6 15 8 15 10 19 8 11.7 10

Daily Demand 9 8 10 13 1 7 5 9 13 13 4 8.4 9

Daily Activity 10 15 13 22 9 17 6 19 17 28 9 15 15

0

5

10

15

20

25

30

Dr Newson Summary

Analyze

Daily Telephone Activity

6/20/2016

Tues. May 19

Wed. May 20

Thurs. May 21

Mon. May 25

Tues. May 26

Wed. May 27

Tues. June 23

Wed. June24

Thur. June 25

Mon. June 29

Tues. June 30

Phoned for Appointment 6 3 7 10 1 7 3 5 12 9 4

Phone calls for other reasons 3 3 0 6 2 3 7 8 8 6 6

Total Phone Calls 9 6 7 16 3 10 10 13 20 15 10

0

5

10

15

20

25

The Newson Twosome’s Project

6/20/2016

Improve

What improvements did our team come up with?

What changes were implemented?

• Head set purchased to allow more calls to be answered

• Printer was purchased for each exam room

• Scheduling template changed to reflect same day appointments

• 5S of exam rooms and supply room

• Communication- Signs posted re new same day access booking and a letter was given to each patient

• Huddles to review the clinic/patient needs for the day

5S

6/20/2016

Results Template changes resulted in more same day apts.

Headset allowed more calls to be answered/more same day appointments booked

5S of exam room and supply rooms saved time in looking for items

Printer in exam rooms reduced wasted time

Huddles resulted in improved flow and being better prepared.

Signs and letters saved staff from explaining to each patient/ showed they were trying improve access

TNAA improved to 0-1 day.

TNAA

6/20/2016

19

13 15 15

30

13

6

1 1 0 0 1

D

A

Y

S

Dr. Newson (July 2015 - Feb 2016)

Control

Daily Huddles

Ongoing tracking of the number of same day appointments

available to ensure 80% of appointments are available at

the beginning of each day.

Continue to track 3rd available appointment (TNAA)

Lessons Learned

Being prepared for the day makes the day flow smoother, is

less stressful and prevents surprises.

We noticed that we are now seeing a new demographic of

patients…everyone now has access to care.

Having better access makes for happier patients and happier

staff.

5S is worth the effort!

The Team!

Dr Kristy Newson and Laura Beth MacLeod