Our client is one of the most progressive and integrated healthcare organisations in the United States. They have hundreds of primary care physicians and specialists providing dedicated physician coverage and high-quality medical services.
>$10 milbenefits from identified opportunities
326%improvement in on-time performance
33%reduced lobby wait–time
68%reduction in average medical examination delay
36%improvement in compliance to After-Visit Summary (AVS) printing
The group wanted to increase performance of its practices, allowing for better capacity utilisation and increased patient satisfaction to deal with the increasing demand for services. We discovered that the organisation was largely missing structured management tools such as data-driven KPIs, short interval control rounding, variation analysis, action logs and performance reviews. This prevented the realisation of continuous improvements. There was also a significant overlap of responsibilities and accountability which resulted in wasted resources.
Communication throughout the group was also ineffective and unstructured. As a result, best practices were not shared, communicated or even made known between practices. Workload allocation varied greatly between practices while a governance model that ensured staff accountability for performance did not exist. Patient slots in same-type practices varied. There were also significant differences in how waiting times were managed and how patients were assisted between practices.
What we did
Renoir set up a task force together with the company to oversee all initiatives and established a feedback loop for process changes and data credibility. Open dialogue was initiated among physicians, senior leadership, clinical support personnel and the client’s task force to discuss processes identified at the site level, applicable Key Performance Indicators, and desired targets for the clinics to achieve.
We mapped clinic-level processes such as patient check-in, clinical rooming as well as analysing the Group’s management control systems. Data capability queries as well data credibility concerns were also looked into.
Created better access to care
Secretaries’ and scheduling coordinators’ workflows were adapted and turned into a standardised checklist for scheduling appointments. The new “every patient, every time” mentality combined with minimum provider-patient weekly contact hours reduced variability in daily slot availability.
Based on patient volume and employee productivity, clinics were often overstaffed. Benchmarks were used to identify appropriate staffing levels. Flexing rules were written and implemented across all clinics.
Improved patient satisfaction
The team developed a tool that provided site-level transparency of patient flow. Employees were held accountable for proactive monitoring of patient arrival schedules through a “daily weekly operating report” (DWOR). As a result, lobby wait times was reduced and there was a stricter adherence to appointment punctuality.
Improved physician satisfaction
Changing the “silo” approach to pod staff responsibilities at multi-provider clinics increased staff availability to providers’ needs. The implementation of a systematic patient tracking mechanism enabled pod staff, providers and front desk personnel to know where each patient was within the patient flow. Coupled with a formalised communication process for providers, secretaries were able to predictively adjust patient expectations before delays occurred.
Daily patient volume was matched with appropriate levels of staffing. The expanding flexibility in the staffing float greatly reduced overtime costs.
Better performance management
We established weekly performance reviews with key staff members and service providers at all clinics to address variances to services provided. The development of the performance management report in the form of the DWOR was instrumental in creating a culture of accountability and action in the organisation.
With Renoir’s guidance, best practices were adopted throughout the group. Management control systems and work processes were also standardised across all clinics. This improved productivity and capacity utilisation, whilst it reduced both patients’ waiting time and overtime cost.
More than $10mil was gained from identified benefits.
After the changes, patients received the best quality service in the most predictable manner possible.
There were 326% improvement in first appointment on-time performance, 33% reduction in lobby wait time, 68% reduction in first appointment average examination delay and 28% reduction in patient throughput.
For service providers, there was a 102% improvement in overall on-time performance, 55% reduction in overall average examination delay and 36% improvement in compliance to AVS printing.
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