HOPE VALLEY — Wood River Health Services is working with a Colorado consulting firm, Coleman Associates, to improve efficiency for medical personnel as well as clients.
Director Alison Croke said patients had begun complaining that they were waiting longer for appointments. Providers at the center were also taking more work home because they could not complete it during the day.
“We recently heard from our patients that it’s becoming harder to get an appointment,” she said. “We also value not only our patient satisfaction but our provider satisfaction. It’s important for us to retain our providers and make sure they’re happy coming to work, not taking work home, work-life balance.”
Using a portion of a $110,000 grant from the federal Health Resources and Services Administration, an agency of the U.S. Department of Health and Human Services, Wood River hired the consultant to streamline its operations.
“I found them in talking to another health center in a different part of the country,” she said. “They were having similar struggles and they referred me to these folks.”
Croke described the program, which Coleman calls "rapid dramatic performance improvement," as having four main goals: To shorten wait times for appointments; reduce waiting times at the center; shorten “cycle” times (the total time a patient spends at the center); and improve conditions for providers.
“Increase the number of patients we see in a day, therefore better serving the community and meeting our mission and improving patient satisfaction; decrease the cycle time, again with the goal to increase patient satisfactio,n and then increase overall provider and staff satisfaction,” Croke said. “The goal is, at the end of the day, providers are done with their charting and they’re not taking work home.”
Coleman coaches began working with the first of seven provider and staff teams a week and a half ago and are now training a second team. The program is expected to last about 12 weeks, but Croke said it was already producing tangible results for the first team to receive the training.
“We track lots of different measures,” the director said. “A common metric that practices will get is how many patients do you see in an hour, and we’ve already been able to increase that number. We’ve also been able to reduce the cycle time, so at the beginning, with this one team, the cycle was about 54 minutes. We were able to get that down to between 36 and 40 minutes.”
Coleman coach and trainer Adrienne Mann said the improvement at Wood River had been significant.
“They had a 29 percent decrease in their cycle times overall and they had a pretty significant increase in their productivity by the end,” she said. “It’s on a small scale right now, but at the end of the 12-week period, I estimate that it will be across the board there.”
Coleman also introduced a low-cost improvement that Croke said had an immediate benefit for team members: walkie-talkies.
“They loved it, because the front desk can walkie-talkie back,” she said. “They don’t have to get up from their desk, walk away from the window, go find where the person is. They just walkie-talkie to the medical assistant and say ‘your patient is 10 minutes early. Would you like to see them now?’”
Mann said improving communication was a key to improving overall efficiency.
“We think about it as engineering communication, being really intentional in communication,” she said. “What that does, in addition to just keeping everybody in the loop, is build teamwork, which is really important. You just have to communicate really consistently, and for them, the building has such long hallways that you just couldn’t run into people, which makes it really challenging, which is why we find the walkie-talkies so effective.”
Another initiative is a practice called “quick start," in which the medical assistant and the doctor are in the room at the same time, so the patient doesn’t have to wait for the doctor to come in after the medical assistant has done the initial screening.
“When the patient arrives, there’s their doctor, waiting for them in the exam room,” Croke said. “Patients really like it.”
The improvements are expected to benefit medical personnel as well as patients, something Mann said was important for rural health centers, which sometimes find it challenging to attract and retain providers.
“Especially in a rural community, it’s really important because there’s already a shortage of providers and if you start burning people out, it hurts the community as a whole,” she said.