February 9, 2012

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Reining in wait times

Department: Cleveland Heights Internal Medicine

Problem: Low Patient Satisfaction Scores (PSS); wait times and patient access were identified as primary culprits

Value compass: Best service, best place to work

Metric: PSS scores

First small test: Increased communication with patients, and instituted measures to diminish the perception of long wait times when they are inevitable. Those measures include having nurses, who use a script for consistency, let patients know if a physician is running late and keep them updated. They also have stocked more magazines in the waiting and exam rooms. Medical assistants or LPNs also let patients remain in the main waiting area as long as possible, to minimize the time they sit alone in the exam room.

Result: PSS scores rose from 62.6% to 71.2% from Q2 of 2007 to Q1 of 2008

Next step: Institute some 21st Century Care Innovation Project initiatives, such as phone visits, to help improve patient access

Labor co-leads: Cherie Merritt, RN, ONA, and Deloris Jacksonbey, LPN, OPEIU Local 17

Management co-lead: Traci Sopata, RN, department manager and team lead

Physician co-lead: Delilah Armstrong, MD

Biggest challenge
Building a cohesive team out of two adjacent internal medicine departments. “I think the biggest barrier for us was change itself. As the organization was transforming we were tasked to transform ourselves,” Merritt said.

Advice to other teams: Focus on what is within your power of influence, said Jacksonbey. Sopata added: “It takes a whole team. Without everyone in agreement that change is needed, you can’t change. It’s important to develop cohesion and get the staff behind it.”

Side benefits:

  • Improved inter-departmental communication; a strong sense of camaraderie developed between the two medicine teams. “I really think it’s just been our communication and meshing of the teams,” Merritt said. “Because we were doing things one way on one side and a different way on the other side. If something worked well on one side, we’d incorporate it on the other side. So everyone was on the same page.”
  • Increased flexibility as a result of nurses floating back and forth between the two departments.
  • New daily huddles have improved general communication and keep staff and doctors updated on measures being tested.

“We all had the same goal, we just had to come together,” Jacksonbey said.