Losing the wait: improving patient cycle time in primary care

Area of Science:

• Healthcare Management
• Process Improvement
• Primary Care

Background:

• Prolonged wait times in primary care clinics negatively impact patients, physicians, and staff.
• Reducing patient cycle time can enhance patient experience, staff satisfaction, and access to care.
• Existing studies often focus on front-end efficiency, neglecting the entire patient visit cycle.

Purpose of the Study:

• To decrease the total patient visit cycle time to under 60 minutes within one year.
• To improve overall patient satisfaction with primary care services.
• To identify key factors contributing to cycle time reduction and patient satisfaction.

Main Methods:

• Engaged clinic teams in brainstorming solutions for efficiency.
• Implemented regular measurement and reporting of cycle time.
• Conducted regular meetings to plan and execute rapid improvement cycles.
• Utilized Medical Assistant (MA) staff as flow coordinators.

Main Results:

• Achieved a 12% reduction in cycle time, from 71 to 65 minutes, in the first year.
• Maintained high patient satisfaction scores, with patients feeling they received adequate time with their doctor.
• Sustained and further improved cycle time to 60 minutes by April 2019, despite increased patient volume.

Conclusions:

• Team engagement, frequent measurement, adequate staffing, and the role of MA staff as flow coordinators are crucial for reducing cycle time.
• Sustained improvements in cycle time are achievable and can coexist with high patient satisfaction.
• Further optimization requires analyzing post-rooming wait times and physician workflow.