Decreasing Wait Time in Family Planning Clinic for New Physicals

NAME OF HEALTH DEPARTMENT: Rockingham County Health Department

PROJECT TITLE: Decreasing Wait Time in Family Planning Clinic for New Physicals

Diane Stott  
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Project Overview

Project Aim:
Rockingham County Health Department aims to decrease the time (check-in until check-out) for new client physicals in the Family Planning Clinic by 50%. We plan to accomplish this improvement by October 1, 2011. Decreased time is important because it will improve staff efficiency and client satisfaction. As we lower the time per client seen, staff will be able to see more clients per day. Clients will be more satisfied by spending less time in the clinic. Satisfied clients are more likely to keep appointments and promote clinic services in the community. We will accomplish our goals by using the QI 101 methods and tools learned in the PH QI 101 course and Lean Kaizen Event.


  • 90% or more of new client physicals will be completed within 90 minutes or less (check-in to check-out). Current standard is 180 minutes.
  • Maintain a 90% or better show rate for scheduled new client physicals. Current standard is 74%.
  • Maintain a 90% or better positive satisfaction score from a statistically significant random sample of new client physical recipients. Current standard is 75%.
  • Maintain a 30% State/70% County (or better) funding ratio in Family Planning Clinic.

Project timeframe:
March 2011 to October 1, 2011

How was the need for the project determined?
RCHD does monthly client satisfaction surveys.  There are always comments on the amount of time it takes to have a new Family Planning Physical.   The client is always pleased with the service and staff but complains about the amount of time they spend at the Health Department.

Does this quality improvement project link to accreditation?
Yes.  Everything is linked to accreditation.   This is also linked to the Title X program and grant funding. 

Areas for Improvement and Change Ideas Implemented

Improvement 1
Three forms were compiled into one, with input from the State Nurse Consultant.  This cut down on the time it took to do paper work.  Patients were able to complete part of this form decreasing nurse completion time. 

Improvement 2
All clinical rooms were set up identical, having the needed forms and brochures in each room.  The workup room desk was stocked with all needed forms and brochures also.   This cut down on the nurses leaving the rooms to get forms, brochures and other needed paperwork.

Improvement 3
The nurses that interview the quickest were identified and assigned/encouraged to do all the interviewing if possible and the other nurses were assigned other tasks.

Improvement 4
Management support started bringing the first three clients in the morning straight back into the clinic area to cut down on that wait time.


Overall Improvements

  • The new form cut down on paper work.
  • Eliminated duplicated work.
  • By having all the rooms set up the same with all needed forms and brochures cut down on time the nurses spent leaving the room to acquire the needed information.
  • The nurses who interview the quickest saves time.
  • By having the clients brought straight back to clinic has saved time.

Lessons Learned:

  • Kaizen Event was ‘feared’ prior to the event, but was a great experience for the team.  Much work was accomplished.  It was an important step to the entire process.
  • The fresh eyes member of the team brings new and different ideals that can change the most important item because they are not “invested” in the current process.

Programs supported by:

BlueCross BlueShield of NC FoundatoinThe Duke Endowment

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