One aspect of reducing waste in health care involves reducing wasted time. Health care professionals waste time when the systems that support the delivery of care are inefficient, requiring rework, redundancy, or work-around solutions. Patients waste time waiting weeks or months to get an appointment, waiting in the waiting room, or for test results.
Once notorious for long wait times for appointments, the Veterans Health Administration worked with IHI for years on a massive initiative to improve access to timely appointments across more than 1800 primary care, audiology, cardiology, eye care, orthopedics and urology clinics.
In the Veterans Affairs New Jersey Health Care System, staff applied advanced access strategies first to primary care clinics, where same-day appointments are now routinely available, and then spread those strategies to specialty clinics, including urology. In addition to working down the backlog of appointments — a challenging but ultimately rewarding process that usually requires adding appointments and clinic hours for a finite period of time — staff also reduced the number of appointment types to smooth out scheduling challenges, reduced demand by working with primary care physicians on defining appropriate consults, and created templates for documentation and for ordering certain medications.
The results? Average waiting time for next-available urology clinic appointments dropped by more than 80 percent. By the end of 2006, wait time for a urology appointment averaged about 15 days, down from more than 90. Not surprisingly, both physician and patient satisfaction has increased significantly.
06/01/2008
