Kavous Roumina, Ph.D. Richard Hill, M.B.A. Walter H. Henricks, M.D. Cleveland Clinic

1. Capture, Analysis, and Management of Patient Wait Times for Outpatient PhlebotomyPathology Informatics 2010 Kavous Roumina, Ph.D. Richard Hill, M.B.A. Walter H. Henricks, M.D. Cleveland Clinic

2. Background and Objective • Patient satisfaction is a point of emphasis in healthcare organizations today. • The time that patients wait for outpatient phlebotomy directly impacts their satisfaction. • Objective: devise a simple yet efficient system to capture and analyze time interval between patients’ arrival at the phlebotomy location and entry into the phlebotomy room

3. Technology - Patient Wait Time Study (PWTS) system • Web-based application (ASP.NET, Microsoft) captures raw data real-time • Second component (VB.NET, Microsoft) batch-processes, validates, and stores the data in a database application (Access, Microsoft).

4. Process - PWTS System • Select the study location

5. Process - PWTS System • Patient given card and Start Time (green side) scanned upon patient’s arrival • Patient keeps the card

6. Process - PWTS System • Start time scanned

7. Process - PWTS System • Start time processed

8. Process - PWTS System • Scan Stop Time (redside) when patient called for phlebotomy (card is returned)

9. Process - PWTS System • If there is a cause for any delay in processing, a pre-defined reason is selected. • Reasons for delay enables better categorization of potential problems.

10. PWTS Database Reports • Generated shortly after the completion of the study. • Grouped by region, location, day-of-week, etc. • Available for a “rolling” 13 month period (to allow for comparisons). • Available as PDF on the intranet

11. PWTS Database Report Definitions • Patients Waiting More Than 20 Minutes: • Count of wait times 20 minutes or longer, grouped by the “Reason Delayed.” • Patients Waiting More Than 20 Minutes – Averaged: • Average wait times and the number of patients who waited 20 minutes or longer. • Statistical Summary: • Min, max, and average wait times as well as the number of patients. Excludes entries that specified a “Reason Delayed.”

12. PWTS Database Report Definitions • Visit Counts by Time Intervals: • Count of patients who waited 5, 10, 15, ... minutes. • Visit Counts by Time of Day: • Count of patient visits for each hour of operation. • Wait Time Details: • All validated and processed data.

13. PWTS Results • Mgmt. Scorecard based on PWTS reports (single month’s study), across locations Across locations

14. PWTS Results • Mgmt. Scorecard based on PWTS reports (single location, “rolling” 12 months):

15. Results and Impact – PWTS System • PWTS system has been implemented at 23 outpatient locations across Cleveland Clinic Health System • 184,325 visits have been captured at initial (17) locations over 19 months, averaging 570 visits/week/location. • Statistical reports are available within hours of completion of measurement period (one week/mo.), compared to weeks with previous manual method

16. Results and Impact – PWTS System (cont’d.) • Analysis of data has enabled better distribution of personnel/resources at various locations and across various times of the day. • Timely availability of such data has, for the first time, recently enabled attainment of the goal of maximum permissible wait times (20 minutes) across all participating locations.

17. Conclusions – PWTS System • An effective, simple, yet robust system has enabled easy capture and rapid analysis of wait times for outpatient phlebotomy, an area in which laboratory directly impacts patient satisfaction. • PWTS provides management data that helps focus resources where necessary, keeping wait times within set targets. • System is deployable, without major modifications, in any setting involving patient waits such as physician offices, emergency rooms, radiology, and others.