Journal
BMJ OPEN QUALITY
Volume 10, Issue 4, Pages -Publisher
BMJ PUBLISHING GROUP
DOI: 10.1136/bmjoq-2021-001550
Keywords
ambulatory care; paediatrics; quality improvement
Funding
- NIH Medical Scientist Training Programme T32 grant [NIGMS 2T32GM008244--33]
- University of Minnesota Health (MHealth) Quality Improvement Collaborative
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By implementing a checkout sheet and staggered start times, this study effectively reduced patient wait time in a paediatric rheumatology clinic, leading to a decrease in variation and mean wait time.
Our paediatric rheumatology clinic has experienced inefficient patient flow. Our aim was to reduce mean wait time and minimise variation for patients. Baseline data showed that most waiting occurs after a patient has been roomed, while waiting for the physician. Wait time was not associated with a patient's age, time of day, day of the week or individual physician. We implemented a checkout sheet and staggered start times. After a series of plan-do-study-act cycles, we observed an initial 26% reduction in the variation of wait time and a final 17% reduction in the mean wait time. There was no impact on patient-physician contact time. Overall, we demonstrate how process improvement methodology and tools were used to reduce patient wait time in our clinic, adding to the body of literature on process improvement in an ambulatory setting.
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