How to Get All Aspects of Flow In Sync
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- Bernadette Bennett
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1 Friday Sept. 9, 2016 am How to Get All Aspects of Flow Where there s a problem. There s a solution. Where there s a problem There s a solution.
2 What is Flow? Doctors Arrival Check-in Consultation Patients Staff Facility Scheduling www. Page 1
3 How to Get All Aspects of Flow Components of Flow Components of Flow www. Page 2
4 Components of Flow + Line at reception + Waiting room full + Doctors running late + Back office complains front office too slow + Front office complains back office too slow +Provider out of pod during session + Provider showing up late + Support staff not available + Communications require walking +Staff/Docs seem rushed/busy www. Page 3
5 Observe the flow Magnitude of obstruction Benefit, Cost Improve Measure - current Dr. Birdie Date Timing Patients Start Time End time Total seen Seen/Hour New No shows Work-ins 09/13/10 8:25:00 AM 12:54:00 PM /13/10 1:25:00 PM 5:38:00 PM /15/10 8:15:00 AM 12:04:00 PM /15/10 1:15:00 PM 4:54:00 PM /16/10 1:05:00 PM 4:24:00 PM Averages Measure output capacity Dr. Birdie Task Timing Distribution Total Start Time End time Practice Staff Lost find next patient 8:25:30 AM 8:26:00 AM 0:00:30 0:00:30 review health record 8:26:00 AM 8:28:23 AM 0:02:23 0:02:23 Exam 1 8:28:23 AM 8:35:59 AM 0:07:36 0:07:36 look for staff 8:35:59 AM 8:37:14 AM 0:01:15 0:01:15 Exam 1 8:37:14 AM 8:39:19 AM 0:02:05 0:02:05 dictate 8:39:19 AM 8:40:42 AM 0:01:23 0:01:23 walk 8:40:42 AM 8:41:05 AM 0:00:23 0:00:23 talk in hall 8:41:05 AM 8:41:58 AM 0:00:53 0:00:53 no patient 8:41:58 AM 8:45:20 AM 0:03:22 0:03:22 www. Page 4
6 Identify +No patient ready +Provider looking for staff, next patient, +Provider showing patient way out +Provider leaving pod +Provider handling own chart Measure output capacity Dr. Birdie Task Timing Distribution Total Start Time End time Practice Staff Lost find next patient 8:25:30 AM 8:26:00 AM 0:00:30 0:00:30 review health record 8:26:00 AM 8:28:23 AM 0:02:23 0:02:23 Exam 1 8:28:23 AM 8:35:59 AM 0:07:36 0:07:36 look for staff 8:35:59 AM 8:37:14 AM 0:01:15 0:01:15 Exam 1 8:37:14 AM 8:39:19 AM 0:02:05 0:02:05 dictate 8:39:19 AM 8:40:42 AM 0:01:23 0:01:23 walk 8:40:42 AM 8:41:05 AM 0:00:23 0:00:23 talk in hall 8:41:05 AM 8:41:58 AM 0:00:53 0:00:53 no patient 8:41:58 AM 8:45:20 AM 0:03:22 0:03:22 Measure output capacity Dr. Birdie Task Timing Distribution Total Start Time End time Practice Staff Lost find next patient 8:25:30 AM 8:26:00 AM 0:00:30 0:00:30 review health record 8:26:00 AM 8:28:23 AM 0:02:23 0:02:23 Exam 1 8:28:23 AM 8:35:59 AM 0:07:36 0:07:36 look for staff 8:35:59 AM 8:37:14 AM 0:01:15 0:01:15 Exam 1 8:37:14 AM 8:39:19 AM 0:02:05 0:02:05 dictate 8:39:19 AM 8:40:42 AM 0:01:23 0:01:23 walk 8:40:42 AM 8:41:05 AM 0:00:23 0:00:23 talk in hall 8:41:05 AM 8:41:58 AM 0:00:53 0:00:53 no patient 8:41:58 AM 8:45:20 AM 0:03:22 0:03:22 www. Page 5
7 Measure output capacity Practice Watch Summary Timing Patients Total Current Practice Potential Doctor Start Time End time Seen Time Pts/Hr Time Pts/Hr Dr. Birdie 8:10:00 AM 12:08:00 PM 22 3:58: :22: Dr. Eagle 8:05:00 AM 11:52:00 AM 24 3:47: :28: Dr. Par 8:18:00 AM 12:25:00 PM 20 4:07: :47: Dr. Bogey 1:44:00 PM 6:33:00 PM 16 4:49: :01: Measure output capacity Practice Watch Summary Timing Patients Total Current Practice Potential Doctor Start Time End time Seen Time Pts/Hr Time Pts/Hr Dr. Birdie 8:10:00 AM 12:08:00 PM 22 3:58: :22: Dr. Eagle 8:05:00 AM 11:52:00 AM 24 3:47: :28: Dr. Par 8:18:00 AM 12:25:00 PM 20 4:07: :47: Dr. Bogey 1:44:00 PM 6:33:00 PM 16 4:49: :01: Identify Throughput + Conflicting tasks? + Reception / phones + Assist MD/ patient call + Assist MD / counsel patients + Assess time utilization + Communication require walking +Patient ready + Where is provider +Transfer Info/Instructions +Need Assistance www. Page 6
8 Identify Input + Compare rate w/ current output + Assess visit types +# of different types + Effective time of provider + Flow within Template + Not all providers alike + Assess pre-md prep Flow Solutions + Electronic communications +EHR + Light signaling/ Patient tracking systems + Printing patient encounter form Flow Solutions +In sync with doctor output +Plan for work ins and no shows +Patient visit start is before time on provider appointment sheet www. Page 7
9 Flow Solutions +Focus on patients in the office + Self registration/check in kiosks +Base staffing on hourly patient volume + Flow Solutions +Keep MAs in pods more + Eliminate conflicting tasks + Team leader assigned per doctor +Account for additional tasks and doctor support Flow Solutions +Pods + Next patient ready + Delegate non doctor tasks +Doctor start on time + Provide with scribe www. Page 8
10 Process / Space Layout +Operationally based list of rooms +# of Providers in at once +# of Rooms / provider +Group rooms based on service +Beware of over sharing www. Page 9
11 How to Get All Aspects of Flow To contact Tim please call him at , him at or visit his website at www. www. Page 10
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