In fall 2013, we began looking at ways to improve outpatient flow in our clinics. Key areas targeted for improvement included wait times, visits and overall experience. Our ‘Optimizing Outpatient Flow’ project is in full swing and will be complete by the end of 2015. Some key highlights:
1) Information Flow – We are rolling out a new scheduling system for the Outpatient Clinics and Services by December 2015. To enhance this, we are moving to a central check-in desk by the Clinics entrance. This means that all Clinics’ Administrative Coordinators will be stationed at the central location to ensure a consistent presence for patients/families and standard workflow. We are also enhancing Meditech, Providence’s health care information system responsible for patient registration, scheduling, billing and more, to better process outpatient referrals.
2) Resource optimization – A new Outpatient Flow Coordinator has been instrumental in streamlining and centralizing information to ensure the best flow for our patients. We have introduced a Frailty Intervention Team (FIT) in the Assess and Restore program, allowing for quick and easy access for elderly patients at risk to a Providence interprofessional team to mitigate referral to an emergency department. As part of this program, the team can admit patients to one of our Geriatric and Medical Rehab beds when appropriate. We also added a Social Work role to the Assess and Restore program to augment the FIT program. In the clinics, we added a Personal Support Worker to provide support for our outpatients for such things as toileting assistance, transfers and mobility. As part of our resource optimization, clinic nurses now have more time for patient care.
3) Process Changes – Our project teams have been hard at work with staff to implement specific improvements to outpatient classes offered through the Clinics. We have created standard assessment times in our Stroke and Neuro Clinic in order to best meet patient flow demand and continue to work on strategies to manage the waitlist. The coverage process for outpatient therapist illness/vacation has been improved and standardized to match the inpatient process. A satisfaction survey (similar to our inpatient survey) is being used to gauge patient satisfaction and suggestions for improvement.
4) Space – We have made changes to our Clinics space, including improvements to the main waiting room for heating, television viewing and seating. In addition, volunteers now greet patients as they arrive to assist them in finding their Clinic and answer any questions. Educational resources are being improved in the waiting room to provide key resources for patients/families to read. We are also trialing signage improvements in order to best guide patients to their destination. Colour coded floor lines will be spread to all Clinics in the near future. In terms of future space, we have a plan to renovate the B1 and B2 units to best meet the needs of patient flow. By December 2015, the Stroke and Neuro Clinic will move to a newly renovated B2 unit and, by February 2016, the Falls Prevention Clinic will move to a remodeled B1 space (previously held by the Stroke and Neuro Clinic).
Results to date show our Clinics continue to increase their flow of new patients. We have seen improvements in the past year in the way people access our Clinics. Having a new Outpatient Flow Coordinator role has greatly assisted with streamlining the process. The Clinics are also testing ways to mitigate cancelled appointments. Patient satisfaction overall has been consistently high in the Clinics throughout the duration of the project.