Reducing Length of Stay for Pediatric and Adult Patients in a Student-Run Free Clinic: A Quality Improvement...

Bartley Temple (BT), a church-based clinic within the University of Florida's Equal Access Clinic Network, provides care to a predominantly pediatric population as well as adult patients who are uninsured or underinsured. Long patient wait times are known to negatively impact patient satisfaction and clinic efficiency. This study aimed to reduce the median length of stay (LOS) at BT by 25%, from a baseline of 108.8 minutes to 81.6 minutes, through three Plan-Do-Study-Act (PDSA) cycles over six months.

Three four-week PDSA cycles were implemented following baseline data collection for 12 weeks. PDSA 1 restructured officer roles to improve coordination. PDSA 2 introduced a patient tracker and checklist for the check-in volunteers. PDSA 3 optimized volunteer workflow and check-out processes. LOS data was collected using an Excel-based tracking system (Microsoft® Corp., Redmond, WA, USA). Statistical analysis was performed in R version 4.2.2 (The R Foundation for Statistical Computing, Vienna, Austria).

Although the initial goal of decreasing LOS by 25% was not met, the interventions collectively led to a reduction in median LOS, from 108.8 to 94.3 minutes (13.3%). Individually, pediatric patient LOS decreased by 10.2%, while adult patient LOS decreased by 25.0%.

Creating structured officer roles, patient trackers, checklists, and streamlined check-out processes successfully reduces LOS at a student-run clinic for both pediatric and adult patients.