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PATIENT FLOW: FOLLOW – UP REPORT

PATIENT FLOW: FOLLOW – UP REPORT. Agoncillo , Asperas , Cosalan , Tanbonliong ASMIP 2009. BACKGROUND. OBJECTIVES. General Objective This follow-up study seeks to evaluate the current operation system of American Eye Center in terms of waiting lines and patient flow.

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PATIENT FLOW: FOLLOW – UP REPORT

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  1. PATIENT FLOW: FOLLOW – UP REPORT Agoncillo, Asperas, Cosalan, Tanbonliong ASMIP 2009

  2. BACKGROUND

  3. OBJECTIVES General Objective This follow-up study seeks to evaluate the current operation system of American Eye Center in terms of waiting lines and patient flow.

  4. Specific Objectives • Determine statistical trends on patient volume according to: • Time interval in a day • Day of the week • Age group • Chart type • Compare the current and previous trends on patient volume

  5. Evaluate the general flow of patients in the clinic on light and heavy days within the period after the initial study on operations management • Assess the utilization of examination rooms and relate it to patient volume and turnover from optometrist to ophthalmologist • Identify changes in the operation system and relate these to the current patient flow and waiting time

  6. Assess the recommendations from the previous study • Provide recommendations that will improve the waiting lines and patient flow

  7. SIGNIFICANCE OF THE STUDY • Assess and evaluate the current patient flow system being employed • Identify weak and strong points of the system to improve • Provide tools and recommendations to keep the operations of the center as efficient as possible

  8. SCOPE AND LIMITATIONS • Study is based on changes made by a previous study conducted last year • Statistical data from June 2008 to May 2009

  9. DATA COLLECTION

  10. PATIENT VOLUME • All statistical data from June 2008 to May 2009 were taken from log books provided by the reception • Categories • Time intervals • Age • Chart type

  11. PATIENT DATA PROCESSING AT FRONT DESK PER PATIENT CATEGORY Measured the time from when the patient first approaches the reception area until it is stacked in the chart box

  12. TURNOVER FROM CHART BOX TO OPTOMETRIST • Optometrist takes a file and starts to perform the routine or special procedures • Measured the time interval when a patient’s file is stacked into the chart box until an optometrist can accommodate the patient

  13. GENERAL SCREENING • Routine tests: Automated Refractometry, Air Puff Tonometry, Corneal Topography and Specular Microscopy • Start is when the optometrists calibrates the machine and end when the results are released

  14. ROOM USE • All 5 rooms are timed according to usage • Availability of the rooms is an important factor to the patient’s waiting time

  15. OPTOMETRIST ROOM USE • Test the grade of the patient’s eyes using the Snellen and jaegger chart • Specific tests done to patients include color blindness tests, pupillometry and contrast sensitivity test

  16. TURNOVER FROM OPTOMETRIST TO OPHTHALMOLOGIST • Measured by timing the end of the patient’s session with the optometrist until the ophthalmologist is ready to see them

  17. OPHTHALMOLOGIST ROOM USE • There are no private use for physicians, thus they are able to use any available room • The time for room usage is measured from when the doctor meets the patient until their consultation is over

  18. INTERVIEW • Receptionist • Patient categories, scheduling of patients and general information • Records Assistant • Filing system the clinic utilizes • Optometrists • Routine patient flow and equipment being used • Ophthalmologist • Services they offer, routine and special procedures

  19. DATA ANALYSIS • Frequency distribution • Patient category, age group, visit to the clinic according to the time and date • Figures • Patient Volume by Time Interval per Weekday • Patient Volume by Time Interval per Month • Patient Volume by Weekday per Month • Patient Volume by Age Group per Month • Patient Volume by Age Group per Day in a Week • Patient Volume by Chart Type per Month • Patient Volume by Chart Type per Weekday

  20. AVERAGE PATIENT VOLUME BY TIME INTERVAL PER WEEKDAY

  21. AVERAGE PATIENT VOLUME BY TIME INTERVAL PER MONTH

  22. PATIENT VOLUME BY WEEKDAY PER MONTH

  23. PATIENT VOLUME BY AGE GROUP PER MONTH

  24. PATIENT VOLUME BY AGE GROUP PER DAY IN A WEEK

  25. PATIENT VOLUME BY CHART TYPE PER MONTH

  26. PATIENT VOLUME BY CHART TYPE PER WEEKDAY

  27. GENERAL FLOW OF PATIENTS

  28. PATIENT DATA PROCESSING AT FRONT DESK

  29. DATA PROCESSING AT FRONT DESK

  30. TURNOVER FROM CHART BOX TO OPTOMETRISTS

  31. GS: Automated Refractometry Increase in standard deviation and range of values Mean and median decreased Increase in dispersion can be attributed to the increase in sample size

  32. GS: AIR PUFF TONOMETRY Takes the shortest time to complete Decrease in mean duration and standard deviation in this phase Maximum time observed in the later study decreased by a minute as compared to the initial study

  33. GS: CORNEAL TOPOGRAPHY Time increased to 2 min and 5 seconds Median also increased to 2 min Increase in standard deviation suggesting a more dispersed data which represents the time it takes for different optometrists to use the machine Considering the bulk of patients using the machine, there is a significant increase in turnover time

  34. GS: SPECULAR MICROSCOPY There is a significant difference in the minimum and maximum times it takes to use the machine from the previous study Decrease in standard deviation Notable improvement in terms of time management and utility of the machine

  35. OPTOMETRIST ROOM USE A high standard deviation from both studies Optometrist may take as long as 15min and as short as 1 min

  36. TURNOVER FROM OPTOMETRIST TO OPHTHALMOLOGIST The patient waiting for a room to be available Large improvement this year as compared to last year Decrease in the mean time and standard deviation

  37. OPTHALMOLOGIST ROOM USE Ophthalmologists usually perform less tests than optometrists The maximum time may be attributed to consultations that patients and their family may have with the doctors thus resulting to a maximum time similar to that of the optometrists

  38. ROOM UTILITY

  39. CATARACT SURGERY DAY: MAY 26

  40. DURATION OF USE BY TIME INTERVAL PER EXAM ROOM: May 26

  41. LASIK SURGERY DAY: May 29

  42. DURATION OF USE BY TIME INTERVAL PER EXAM ROOM: May 26

  43. ROOM UTILITY ON A SATURDAY: May 30

  44. DURATION OF USE BY TIME INTERVAL PER EXAM ROOM: May 30

  45. CONCLUSION • Statistical trends on patient volume • Peaks before and after lunch • Saturday contains the highest volume of patients • Majority of patients are of working age (19 – 59) • Majority of patients are in the clinic for follow-up (FF)

  46. Comparison of current and previous study • Increase in total number of patients • Increase in GC: 661 – 794 • Increase in FF: 1956 – 1689 • Increase in LS: 132 – 162 • Increase in SX: 221 – 231 • Change in trend according to time interval • Previous study • Linear decline in patient volume • Current study • Two peaks in patient volume (before and after lunch)

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