Using patient flow analysis with real-time patient tracking to optimize radiation oncology consultation visits

BMC Health Services Research

Research

Katy E. French¹  Ashley Kerr²  Julius Weng²  Prajnan Das²  Dorothy Elrod-Joplin²  Amy C. Moreno²  Albert C. Koong²  Quynh-Nhu Nguyen²  Joseph M. Herman²  Utpala Daftary³  John Frenzel³  Thomas Aloia³  Iris Recinos³  Wendi Martinez³  Abdulaziz Alshaikh³  Shane Mesko⁴ 

[1] Chair, Patient Informatics, MD Anderson Cancer Center, Houston, TX, USA;Department of Radiation Oncology, MD Anderson Cancer Center, Houston, TX, USA;Institute for Cancer Care Innovation, MD Anderson Cancer Center, Houston, TX, USA;Scripps MD Anderson Cancer Center, Division of Radiation Oncology, San Diego, California, USA;

关键词: Patient flow analysis;    Clinical efficiency;    Clinical workflow;    Cycle time;    Rooming time;    Waiting time;    Radiation oncology;   

DOI  :  10.1186/s12913-022-08809-2

 received in 2021-12-15, accepted in 2022-11-08,  发布年份 2022

来源: Springer

【 摘 要 】

PurposeClinical efficiency is a key component of the value-based care model and a driver of patient satisfaction. The purpose of this study was to identify and address inefficiencies at a high-volume radiation oncology clinic.Methods and materialsPatient flow analysis (PFA) was used to create process maps and optimize the workflow of consultation visits in a gastrointestinal radiation oncology clinic at a large academic cancer center. Metrics such as cycle times, waiting times, and rooming times were assessed by using a real-time patient status function in the electronic medical record for 556 consults and compared between before vs after implementation of the PFA recommendations.ResultsThe initial PFA revealed four inefficiencies: (1) protracted rooming time, (2) inefficient communications, (3) duplicated tasks, and (4) ambiguous clinical roles. We analyzed 485 consult-visits before the PFA and 71 after the PFA. The PFA recommendations led to reductions in overall median cycle time by 21% (91 min vs 72 min, p < 0.001), in cumulative waiting times by 64% (45 min vs 16 min; p < 0.001), which included waiting room time (14 min vs 5 min; p < 0.001) and wait for physician (20 min vs. 6 min; p < 0.001). Slightly less than one-quarter (22%) of consult visits before the PFA lasted > 2 h vs. 0% after implementation of the recommendations (p < 0.001). Similarly, the proportion of visits requiring < 1 h was 16% before PFA vs 34% afterward (p < 0.001).ConclusionsPFA can be used to identify clinical inefficiencies and optimize workflows in radiation oncology consultation clinics, and implementing their findings can significantly improve cycle times and waiting times. Potential downstream effects of these interventions include improved patient experience, decreased staff burnout, financial savings, and opportunities for expanding clinical capacity.

【 授权许可】

CC BY   
© The Author(s) 2022

【 图 表 】

Fig. 3

Fig. 1