Stop the Press: Hoke County Has Reached Higher Elevation in Primary Care

Measurable QI outcomes were as follows: 1. Decreased overall wait time for Primary Care Clinic patients from 90 minutes to 60 minutes per visit. • Baseline and target: 15–20 patients per week; in January, the wait time at sign-in and eligibility check was 13–43 minutes. • Results: The number of patients seen in February was 17; the wait time at sign-in and eligibility check was 10–36 minutes. • Results: The number of patients seen in March was 27; the wait time at sign-in and eligibility check was 7–30 minutes. 2. Improved patient satisfaction with wait time by 25% of patients scheduled. The target was 10 patients. • Results: 44 surveys were collected from August to November 2013. Patients reported that they were satisfied with the services they received. 3. Percentage of patients who rate their satisfaction with the time spent with the provider as “fair” or “poor” (as indicated on the customer satisfaction survey). • Results: Nine patients rated the services as “fair.”

Other QI outcomes were as follows: • The staff have a better understanding of the clinic process. • Patients are processed through the clinic without problems. • Patients' charts are not waiting to be picked up by medical staff. • Patients who arrive late as defined by appointment policy are being rescheduled instead of being worked into the clinic schedule.

The following lessons were learned: • Things that did not work as planned: Not all employees working in the clinic were using the medical records wait time assessment tool. There were complaints of putting emphasis on writing time rather than caring for patients. • Things the team would do differently next time: Provide immediate training in areas of need for staff, and get input from staff. • Things the team members wish they knew before tackling this project: The seriousness of employees not being able to work together as a team.

As part of the CPHQ QI 101 Program, the QI team involved a sponsor and the process owner (a manager of the process that was addressed) in creating a comprehensive sustainability plan to organize efforts. The team used CPHQ's sustainability checklist to create the plan. The plan/checklist is attached in the QI Tools section. Other plans include the following: • Patient satisfaction surveys will be collected at billing (a box will be placed in the lobby for patients to use). • In the medical records area, old charts will be taken off the floor, and forms will be made easier to reach. • Patient forms needed in the triage and trauma room will be placed in file boxes, labeled, and stored on shelves for staff efficiency. • To improve staff efficiency, a doorbell will be added to alert staff to a ready chart rather the staff member having to walk around to look at the charts.