improved physician access heart and vascular center team members: john roy kathy ragusa sandra...

IMPROVED IMPROVED PHYSICIAN PHYSICIAN

ACCESSACCESSHEART AND VASCULAR HEART AND VASCULAR

CENTERCENTER

Team Members: Team Members: John Roy John Roy

Kathy Ragusa Kathy Ragusa Sandra McCullough, RN Sandra McCullough, RN Thomas McKiernan, MD Thomas McKiernan, MD Heart and Vascular Staff Heart and Vascular Staff

Division of Cardiology StaffDivision of Cardiology Staff

33rdrd available appointment access for available appointment access for NEW patients to the Heart and NEW patients to the Heart and

Vascular clinic was greater than 30 Vascular clinic was greater than 30 days. A review of physician days. A review of physician

scheduling issues identified complex scheduling issues identified complex scheduling processes that varied scheduling processes that varied

from physician to physician. from physician to physician.

Project Goal & Target:Project Goal & Target:Standardize appointment schedulingStandardize appointment scheduling33rdrd available for new patients of 14 available for new patients of 14

days or lessdays or less

NEW PATIENTS

PATIENTACCESS GOAL

SOLUTIONSSOLUTIONS

• Standardized schedulesStandardized schedules– Reduced and standardized visit types from Reduced and standardized visit types from

four to twofour to two• New Patient Visit (NPV)New Patient Visit (NPV)• Return Patient Visit (RPV)Return Patient Visit (RPV)

– Modified pre scheduling messages to be Modified pre scheduling messages to be clear and concise for all schedulers clear and concise for all schedulers throughout the system.throughout the system.

– Developed team scheduling concept with IDX Developed team scheduling concept with IDX and key word list to facilitate scheduling.and key word list to facilitate scheduling.

– Identification of General Cardiology Team in Identification of General Cardiology Team in every message for team scheduling every message for team scheduling capability in IDX. capability in IDX.

SOLUTIONSSOLUTIONS• Increased physician supply Increased physician supply

– Added additional NPV slots to existing schedulesAdded additional NPV slots to existing schedules– Utilized freeze/thaw slots to meet daily acute new Utilized freeze/thaw slots to meet daily acute new

patient visitspatient visits– Added Added “New Patient Only”“New Patient Only” sessions sessions– Ad hoc sessions, even for only 1 patient Ad hoc sessions, even for only 1 patient

• Created Expediter Role – Designated Created Expediter Role – Designated Service RepresentativeService Representative– Reviews daily new patient report to see if patients Reviews daily new patient report to see if patients

are scheduled appropriately and in less than 14 are scheduled appropriately and in less than 14 days.days.

– Reviews daily schedules for accuracy and Reviews daily schedules for accuracy and opportunities to schedule new patients from the opportunities to schedule new patients from the wait list.wait list.

– Serves as a liaison to referring physicians to Serves as a liaison to referring physicians to facilitate scheduling new patients.facilitate scheduling new patients.

SOLUTIONSSOLUTIONS

• EducationEducation– Clinic service representatives were educated Clinic service representatives were educated

not to use “default” when scheduling return not to use “default” when scheduling return patients. patients.

– Educated Cardiology secretarial staffEducated Cardiology secretarial staff• Wait list functionWait list function• How to add/remove patients from the list.How to add/remove patients from the list.• Not to use “default” when scheduling return patients Not to use “default” when scheduling return patients

– Physician communicationPhysician communication• Number of patients on their wait listNumber of patients on their wait list• Collaboration to accommodate patients Collaboration to accommodate patients • Review 3Review 3rdrd available data at monthly division meetings available data at monthly division meetings

NEW PATIENT NEW PATIENT REPORTREPORT

DATE DATE SCHEDULESCHEDULEDD SPECIALTYSPECIALTY MRNMRN

APPOINTMEAPPOINTMENT DATENT DATE

VISIT VISIT TYPETYPE

DAYS TO DAYS TO APPOINTMEAPPOINTMENT NT

5/1/20065/1/2006CARDIOLOGY CARDIOLOGY ELECTROPHELECTROPH 5/16/20065/16/2006 NPVNPV 1515







5/1/20065/1/2006 CARDIOLOGY GENERALCARDIOLOGY GENERAL 7/3/20067/3/2006 NPVNPV 6363










5/1/20065/1/2006 CARDIOLOGY HEART FAICARDIOLOGY HEART FAI 5/19/20065/19/2006 NPVNPV 1818

5/1/20065/1/2006CARDIOLOGY CARDIOLOGY INTERVENTINTERVENT 6/5/20066/5/2006 NPVNPV 3535

5/1/20065/1/2006CARDIOLOGY CARDIOLOGY INTERVENTINTERVENT 5/5/20065/5/2006 NPVNPV 44

RESULTSRESULTS

4,758

5,129

4,400

4,600

4,800

5,000

5,200

FY06 FY07 (Annualized)

GENERAL CARDIOLOGYSUPPLY (ALLOCATED HOURS)

7%

11,807

12,180

11,600

11,800

12,000

12,200

FY06 FY07 (Annualized)

GENERAL CARDIOLOGYNEW AND RETURN APPOINTMENTS

4%

General CardiologyThird Availability New Appointment

Mar

-06

Apr-0

6

May

-06

Jun-

06

Jul-0

6

Aug-0

6

Sep-0

6

Oct-06

Nov-0

6

Dec-0

6

Jan-

07

Feb-0

7

10

15

20

25

30

35

40

45UCL = 45.89

Mean: 31 days

LCL = 15.31

UCL = 18.60

Mean: 13 days

LCL = 7.07

Project PlanningMay-July 06

Project ImplementationAugust 06

Target: 14 days

ANALYSISANALYSIS

• It is important to understand the It is important to understand the complexity and capabilities of complexity and capabilities of appointment scheduling systemsappointment scheduling systems– RulesRules– StandardizationStandardization– Freeze/thawFreeze/thaw– Team schedulingTeam scheduling

• Communication between all areas of Communication between all areas of Cardiology, from the clinic to the Cardiology, from the clinic to the department offices, is critical to effective department offices, is critical to effective appointment schedulingappointment scheduling

NEXT STEPS:NEXT STEPS:

• Continue to use new patient report to Continue to use new patient report to identify scheduling issuesidentify scheduling issues

• Look for opportunities to standardize Look for opportunities to standardize expediter roll and train back up expediter roll and train back up personnel.personnel.

• Develop a plan for expected and Develop a plan for expected and unexpected changes to maintain our unexpected changes to maintain our 14 day goal.14 day goal.

• Share success with other Ambulatory Share success with other Ambulatory specialty clinics.specialty clinics.

improved physician access heart and vascular center team members: john roy kathy ragusa sandra...

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