6. Leverage lean methodologies
Another approach Bon Secours St. Francis is taking is to adopt the concept of “lean methodologies” to re-engineer how patients receive their healthcare. The end result is simplified scheduling and workflow changes, which mean that it’s easier for patients to schedule appointments.
For example, there’s been a dramatic decrease from 120 days to as few as two days for a patient to get a “third next-available appointment,” which is defined by the Institute for Healthcare Improvement as the average length of time in days between the day a patient makes a request for an appointment with the physician and the third available appointment for a new patient physical, routine exam, or return visit exam.
Nuñez’ journey began about eight months ago when his medical group of approximately 300 physicians, which provides services to the healthcare network, kicked off the process of reorganizing how they deliver care. Fifteen of the practices—half are primary care and half are specialty practices—undertook this work, which required both clinicians and administrative leaders to determine the roadblocks to delivering care.
For example, one senior physician was particularly devoted to a “pod” structure at his practice, which means that the exam rooms are clustered in pods around the physician who has dedicated clinicians to help him with patients. After being educated on lean processes—and while working alongside a “very data driven” administrator at the practice--that physician became convinced to break away from the pod system and to have team members rotate throughout the practice to provide care. The end result was that physician, who used to see about 24 patients a day, was able to see approximately four more patients daily.
As a result, the medical group’s HCAHPS score has gone up 7%, says Nuñez. He adds that much of that improvement is driven by increased access to care, which is possible because the practices have simplified appointment types, moved from rules-based scheduling to time-based scheduling, and worked through a backlog of appointment requests.
“Understanding all of that and being able to measure and manage it is key to being able to really improve your access to care. It requires our managers to manage a lot of data and analytics,” he adds.
Aine Cryts is a writer based in Boston.