Stop the Press: Hoke County has Reached Higher Elevation in Primary Care
- Details
- Last Updated on Monday, 09 March 2015 22:16
Ulva Littlea
Health Educator
Hoke County Health Department
683 East Palmer Road
Raeford, NC 28376
Phone: 910-875-3717 ext. 2106
E-Mail:
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Project Summary
- More consistent messages and handling of patients
- Smoother flow thru improved efficiencies
- Reducing appointment reminder letter volume
- Reducing employee wait time to receive medical records to increase the number of patients seen
Background Information on the Area for Improvement
Need for the QI Initiative
How was the need for the QI Initiative determined?The QI Team selected the Primary Care Clinic based on information given by nurses and medical providers of how long it was taking patients to be seen and medical records backing up due to not staff not getting them in a timely manner.
Project Aim:
Project Dates
Initiative Begin Date: September 6, 2013Initiative End Date: May 2014
Accreditation Status
Are you accredited by the NC Accreditation Program? YesAre you PHAB accredited? No
If no, do you plan on applying for PHAB accreditation? No
QI Tools/Methods Used
- Value Stream Map
- PDSA Worksheet,
- Run Charts
- 5 Why's Analysis
- 8 Waste Worksheet
- Surveys
Root Cause
Lack of team work among medical staff.
Implementation of the QI Initiative
The team leader contact all members which were suggested by the Health Director to be participants of the team and scheduled regular weekly meetings. Then each team member was asked to to participant in the Gemba Walk with a patient to document problems they observed in the clinic. Findings and solutions were identified and discussed at regular meetings. There were approximately 22 employees who had contact and participated in the project and 100 or more patients with clinic appointments.
Measurable QI Outcomes
1. Decrease overall wait time for Primary Care patients from 90 minutes to 60 minutes per visit. Baseline and target 15-20 patients week; January-wait time -13-43 minutes at Sign-in and eligibility. Results: Number of Patients seen: February = 17; wait time at sign-in and eligibility = 10-36 minutes Results: Number of Patients seen: March = 27; wait time at sign-in and eligibility = 7- 30 minutes 2. Improve patient satisfaction with wait time by 25% of patients scheduled. Target-10 patients. Results: 44 surveys collected August-November 2013. Patients reported they were satisfied with services they received. 3. Percentage of patients who rate their satisfaction with the time spent with the provider as “fair or poor” (as indicated as on the customer satisfaction survey). Results: 9 patients rated their services as fair
Intangible Benefits
- Better understanding of clinic process by staff
- Patients are processed through clinic without problems
- Patients charts are not waiting to be picked up by medical staff
- Patients who are arriving late as defined by appointment policy are being rescheduled instead of being worked in to the clinic schedule
Areas for Improvement and Change Ideas Implemented
Improvement 1
Patient Satisfaction Surveys to be collected at billing and add a box in lobby for other patient to use.
Improvement 2
Medical records area-Old charts off of floor and easier reach of forms.
Improvement 3
Patient forms need at Triage and Trauma Room placed in file boxes and labeled on shelves for staff efficiency.
Improvement 4
Adding doorbell to alert staff to a ready chart, vs. walking to look, to improve staff efficiency.
Lessons Learned
- The medical records wait time assessment tool was not be utilized by all employees working in the clinic. There were complaints of putting emphasis on writing time than caring for patients.
- Provide immediate training in areas of need for staff and get input from staff.
- The seriousness of employees not being able to work together as team.
