Applying clinical process analysis in patient access.

Abstract

214 Background: Patient access is the entry point for new and established patient registration and scheduling process. It serves as the doorway in aligning the need of the patients to the vision of the organization, ensuring financial viability of all parties involved. The increasing demands for regulatory requirements, changes in reimbursement policies, technological and medical advancement, and steep competition, patient access becomes a vital improvement initiative in many healthcare organizations. In FY 2013, our group, the Clinical Process Analysis (CPA) team was tasked to assess the patient access work processes of our clinic areas. Methods: Through a series of structured group interview meetings, the interdisciplinary team (frontline staff, clinical leadership and financial teams) reflects and articulates their current work processes. These work processes are translated into an electronic process map, inclusive of the activities, job roles, estimated times, probabilities, and opportunities for improvement (OFIs). With these elements, CPA delivers a visual display of current work processes which can be utilized for onboarding, visualization of OFIs, and calculation of direct labor cost. A completion of a facilitated PDSA project further infuses the science of improvement. Results: Six centers completed the CPA projects since September 2013. 98 OFIs identified with 91% identified as efficiency and timely issues. 10 PDSA projects initiated, 50% reached completion and 50% are in progress. Clinical teams continue to work on the improvement projects even after the facilitation were completed. Conclusions: Drawing from system thinking and Time-Driven Activity-Based Costing (TDABC) methodology, CPA provides a comprehensive analysis of the current work flow. This allows for both a clinic specific and institutional comparative analysis for identification, implementation and improvement plan. Through facilitation of an interdisciplinary team, from frontline to leadership, process realities are visualized and work-list of opportunities for improvement are identified and worked on. This enables a quality improvement culture of providers and staff to drive quality and financial improvement.