4c’s clinic redesign operational snapshot july 28, 2005
TRANSCRIPT
4C’s Clinic Redesign Operational Snapshot
July 28, 2005
4C’s Clinic Redesign
Goals: Improved patient satisfactionReduced length of visit (Cycle Time) Increased Productivity Better Teamwork Improved employee satisfaction Improved patient flow
4C’s Clinic Redesign
Strategies:Patient Care TeamsStreamlined movement through clinicAggressive management of resourcesPreparation before the day of the visitFlexibility and Cross-training
4C’s Clinic Redesign
The ModelSpecific Roles and Responsibilities
Registration/CashierMedical RecordsMedical AidesNursesProvidersOther Staff
4C’s Clinic Redesign
Patient Care TeamsConsist of:
Provider MAFloat MA’s Float NurseController (1 per site)Lab Staff (1 per 2 teams)Support Staff as needed
4C’s Clinic Redesign
Streamlined Movement Through Clinic All patients greeted in entry area Eligibility quickly verified Eligible patients with appointments expedited Ineligible (non-current, in need of update) patients
routed to Registration Number of ineligible patients in care areas
minimized Identified need to reconfigure facilities to improve
patient flow.
4C’s Clinic Redesign
Aggressive Management of ResourcesUse of a Controller to monitor status of
patient care in real time.Movement of Walk-in patients into DNKA
slots as quickly as they are identified.Flexible use of available staff as needed.Cross training in tasks to expedite patient
visit.
4C’s Clinic Redesign
Preparation before the day of the visit3 days before visit
schedules are run and charts pulled by Medical Records.
Registration staff reviews eligibility of patients and contacts patients to advise them of what is needed to renew eligibility and answer any business related questions they may have.
4C’s Clinic Redesign
Preparation before the day of the visit (Cont’d)2 days before visit
Float Nurses and MA’s retrieve charts from Medical Records, review charts for completeness
Appointment Staff contact the patient to remind them of their visit and to assess reason for visit.
4C’s Clinic Redesign
The Day of the VisitThe Patient Care Team huddles to discuss
the patients of the day and to address issues before the occur.
GreeterGreets patients, checks eligibility, (currently
eligible patients are sent to the waiting area,others are routed into registration for eligibility verification.)
4C’s Clinic Redesign
Controller (Charge Nurse) Assesses patient flow. Coordinates with Triage and Providers to
accommodate walk-in patients. Troubleshoots and remove barriers to care Assures that pre-work for future dates is
completed in a timely manner. Collects daily data Directs staff as needed to do the job.
4C’s Clinic Redesign
Triage NurseAssesses patients with confirmed eligibility
according to 4C’s Triage Guidelines.Coordinates with Controller to
accommodate walk-in patients in available slots.
4C’s Clinic Redesign
Medical Aide Prepares rooms, welcomes patient, assists
provider with visit. Delivers information as directed by provider. Gives patient a satisfaction survey. Makes follow up appointments as needed. Completes all entries on Session Sheet including
start and end times. Cleans rooms Participates in cross training for enhanced skills.
4C’s Clinic Redesign
Float NursePerforms nursing services, assesses and
Triages according to guidelines, performs nursing visits, performs tasks for Medical Aide as needed.
4C’s Clinic Redesign
Provider Participates in huddle, reviews charts to pre-order
tests, works with Patient Care Team and Controller, allows Controller to direct patient flow, including walk-ins, provides medical care.
Directly communicates with patient regarding complex treatment plans and requests that cannot be accommodated.
Recommends appropriate follow-up, documents visit, assists Patient Advocate and staff in resolving patient complaints and issues.
4C’s Clinic Redesign
Lab StaffPrepares equipment for phlebotomy in
exam room, provides X-ray services, draws blood, processes specimens in lab, returns results to provider when available.
4C’s Clinic Redesign
Greeter/Cashier/RegistrationCharges patients for prescriptions.Thanks patient for coming.Directs patients as needed or to the exit.
4C’s Clinic Redesign
Patient Advocate Meets with patients who have a concern or
complaint, documents complaints, investigates and works to resolve at the lowest level, follows up with patients about resolution of complaint, compiles periodic report of complaints.
Referral Clerk Makes timely referrals, enter them intotracking
system, follows up on status of referrals after the prescribed period.
4C’s Clinic Redesign
StatusFull scale test on July 19th. Issues identified and addressed.Full scale three day test July 26, 27,28th
completing todayWork progressing to address issues
identified in test.
4C’s Clinic Redesign
Anecdotal Information
4C’s Clinic Redesign
Questions?