Improving Care by Decreasing Wait Times: A Military Health System Quality Improvement Project

Area of Science:

• Orthopedic Surgery
• Healthcare Quality Improvement
• Patient Flow Management

Background:

• Patient satisfaction is a key metric in outpatient orthopedic clinics, influencing various healthcare outcomes.
• Identifying and reducing patient wait times is crucial for improving the overall clinic experience.
• This study aimed to pinpoint bottlenecks in patient flow and assess a novel intervention to streamline the process.

Purpose of the Study:

• To identify the specific stages within an orthopedic clinic encounter that contribute to the longest patient wait times.
• To evaluate the effectiveness of implementing an identification card system in reducing overall patient wait times.
• To assess the impact of the identification card system on the duration of patient interaction with healthcare providers.

Main Methods:

• A quality improvement study was conducted in an orthopedic hand surgery clinic at a military treatment facility.
• Data on patient wait times were collected using time sheets completed by staff before and after the intervention.
• The intervention involved a card system designed to track patients and manage their order within the clinic's queue.

Main Results:

• The intervention group showed a statistically significant reduction in time from check-in to being roomed (13 ± 13 minutes) compared to the pre-intervention group (21 ± 19 minutes).
• Overall clinic encounter time showed a trend towards reduction in the intervention group (57 ± 35 minutes) versus the pre-intervention group (66 ± 38 minutes), though not statistically significant.
• Patients in the intervention group experienced an increase in time spent with orthopedic surgeons and occupational therapists.

Conclusions:

• A simple identification card system can effectively decrease patient wait times in outpatient orthopedic clinics.
• The intervention led to a significant increase in direct patient-provider interaction time, particularly with orthopedic surgeons.
• This initiative demonstrates a practical approach to optimizing clinic workflow and enhancing patient care within existing infrastructure.