During a Performance Improvement Boardwalk earlier this year, staff from
Bozeman Health Belgrade Clinic demonstrated how they’ve made improvements
in putting patients first by responding to concerns about access to care.
Providers and staff recognized an opportunity existed “to improve
the process of cycling acute patients, beginning with patient check-in
and ending with patient check-out,” said Damian Guillen, Belgrade
Clinic registered medical assistant and Bozeman Health Quality Department
performance improvement coordinator.
To meet the goal of reducing “cycle time” (number of minutes
patients are in the clinic) by 10 percent for acute care patients, the
25 staff members instituted new guidelines at the beginning of 2015 in
how provider time is scheduled and how patients are prepared to be seen
by their provider.
Depending on the patient’s reason to seek care, the front office
booked providers for 15 minutes with a patient for conditions such as
skin rash, sore throat or vomiting, and 30 minutes for more complex issues
such as chest pain, depression or abdominal pain. Additionally, they scheduled
patients needing imaging only when a technician was available, and provided
triage with a nurse for conditions such as neurological issues or high
blood pressure to ensure the patient was seen in a timely manner.
Also, Belgrade Clinic nurses prepped patients for their specific conditions,
ensuring bandages were removed from a patient’s wound, or collecting
and analyzing specimens as required so results were available when the
doctor entered the examination room.
After a year of using the new protocol, Guillen said, the Clinic met its
goal, as visit times for acute patients dropped from 51 minutes to 46.
The four family physicians were able to increase the number of patients
seen daily from 10-12 up to 12-16 without feeling rushed. Patients have
responded positively as well, commenting on quality of care and how effectively
staff use their time with patients.