Improving Scheduling Processes by

Q's:

mpike24 — 2024-02-10 19:52:08 UTC

As an informatics nurse developing a patient-centric scheduling and pre-check in mobile app, what features, and layout would you utilize to ensure a human factor design and human-technology interface that engages the end user and guarantees overall utility? _{(McBride & Tietze, 2022).}
Consider the healthcare system or EHR at your facility, and rate it in the realms of possession, form, place, time, actualization, and goal utility. Where can your facilities’ healthcare system be more useful, reliable, viable, and ethical in helping you complete your nursing responsibilities and patient care interventions? _{(McBride & Tietze, 2022).}

References

mpike24 — 2024-02-10 19:53:22 UTC

_{Ala, A., Alsaadi, F. E., Ahmadi, M., & Mirjalili, S. (2021). Optimization of an appointment scheduling problem for healthcare systems based on the quality of fairness service using whale optimization algorithm and NSGA-II.}_{Scientific reports}_,₁₁_{(1), 19816.}_{https://doi.org/10.1038/s41598-021-98851-7}

_{Davis, M. A., & Rawson, J. V. (2024). JRCERT update. Change management: An overview of 3 models of change.}_{Radiologic Technology, 95}_{(3), 228–234.}

_{Grot, M., Kugai, S., Degen, L., Wiemer, I., Werners, B., & Weltermann, B. M. (2023). Small changes in patient arrival and consultation times have large effects on patients' waiting times: Simulation analyses for primary care.}_{International Journal of Environmental Research and Public Health}_,₂₀_{(3), 1767.}_{https://doi.org/10.3390/ijerph20031767}

_{Jen, W. Y., Chan, Z. Y., Lee, Y. M., Ng, N., Tan, B., Teo, C., Wong, Y. P., Chee, C. E., Chee, Y. L. (2023). Reducing chemotherapy waiting times in the ambulatory setting of a tertiary cancer centre using a Design Thinking approach.}_{Cancers, 15}_{(18), 4625.}_{https://doi-org.ju.idm.oclc.org/10.3390/cancers15184625}

_{McBride, S., & Tietze, M. (2022).}_{Nursing Informatics for the Advanced Practice Nurse}_{(3rd ed.). New York, NY: Springer Publishing.}

_{Pisharody, V. A., Yarmohammadi, H., Ziv, E., Sotirchos, V. S., Alexander, E., Sofocleous, S., & Erinjeri, J. P. (2023) Reducing wait times for radiology exams around holiday periods: A Monte Carlo simulation.}_{Journal of Digital Imaging, 36}_{(1), 29-37.}_{https://doi-org.ju.idm.oclc.org/10.1007/s10278-022-00728-2}

Process to be approved: Scheduling Process

mpike24 — 2024-02-10 20:11:40 UTC

The process of scheduling patients was analyzed in it's entirety. With the goal of improving the ongoing staff workflow issues (Grot et al., 2023), patient equality and satisfaction increase as well. Scheduling processes begin with the appointment request and extends throughout the patient's visit. Through streamlining these processes, patient wait times were reduced as appointment accuracy increased.

Process scope

mpike24 — 2024-02-10 20:21:22 UTC

_{Steps considered in the scheduling process:}

_{Appointment request (marks the beginning)}
_{Appointment confirmation}
_{Patient's arrival to scheduled appointment}
_{Patient check-ins}
_{Patient completes check-in and waits for RN}
_{Patient arrives to a room and appointment begins}
_{Appointment completion - further appointment requested may be ordered (may mark the end if no further appointments are necessary)}
_{Patient schedules the ordered follow-up appointment (marks the end)}

Project Objectives

mpike24 — 2024-02-10 20:46:57 UTC

Reduced patient check-in times
1. Measured in minutes
2. Equation: previous average check-in time vs. check-in time after implementing scheduling change
Increase appointment scheduling accuracy
1. Measured in percentage
2. Equation: Scheduled start time (SST) compared to Actual start time (AST), measuring deviation
Decrease missed appointments
1. Measured in percentage
2. Equation: previous missed appointment average vs. current missed appointment average after the scheduling change

Business Case

mpike24 — 2024-02-10 21:00:23 UTC

The scheduling process should be approached while appreciating the complexity and impact on overall patient and staff satisfaction. Patient satisfaction relies on a multitude of factors, however, wait times and timely visits are two that improved scheduling processes can directly affect. Streamlining operations can also optimize finances and reduce organization costs (Ala et al., 2021) and benefit the clinicians’ workflow.

Customer benefits

mpike24 — 2024-02-10 21:07:36 UTC

Internal customers:

Efficient workflows
Decrease workloads
Appropriate resource allocation
Satisfaction

External Customers:

Decreased wait times
Fair healthcare access
Increased and improved resources
Satisfaction

Team members

mpike24 — 2024-02-10 21:19:27 UTC

Project Manager/Team Leader: Erica Garces

Responsible for team and project operations
Streamlines project to ensure timely and careful completion

Data Analyzation: Justin Martinez

Literature search
Focus on the current workflow
Provide project improvement suggestions

Clinical Support: Megan Pike

Ongoing observation of processes
Streamlining "go-live" and providing staff support
Serves as the staff's "voice"

Project Improvement: Nancy Alexis

Evaluation and analyzation of processes
Educates staff and validates concerns

Current state workflow map

mpike24 — 2024-02-10 21:24:45 UTC

Appointment barriers were analyzed, considering factors that are controllable and need improvement.

Future state workflow map

mpike24 — 2024-02-10 21:28:20 UTC

Partnering with SDOH-related agencies and allocating resources, addresses barriers contributing to missed appointments. Improved technology processes also contributes to this, as well as the appointment accuracy and individualization of care using data analytics.

Required support

mpike24 — 2024-02-10 21:29:48 UTC

Clinician cooperation (physicians, nurses, patient support specialists, etc.)
IT staff assistance
Various discipline staff management
Operations

Schedule

mpike24 — 2024-02-10 21:46:49 UTC

Start: Identification of a scheduling issue or necessity for change
1 month after start: Current scheduling processes analyzation and development of current state workflow map
2 months after start: Choose improvement process and develop future state workflow map
3 months after start: Project approval and planning for implementation
~6 months after start: Project objectives are met and metrics improved

Workflow and process testing

mpike24 — 2024-02-11 21:02:50 UTC

Assess process efficacy, consistency, authenticity, and ethicality (McBride & Tietze, 2022).
Multi-disciplinary evaluation using programs like TigerConnect (Jen at al., 2023).
Monte Carlo and Computer simulation strategies (Pisharody et al., 2023).
Fishbone diagram
Real-time audits

Workflow and process training

mpike24 — 2024-02-11 21:12:44 UTC

Shadowing templates
Staff conferences
Online modules
Live computer simulations
Transtheoretical Model usage to assist with compliance
Diffusion of Innovation Model usage to assist with acceptance (Davis & Rawson, 2024).

"Go-live" management

mpike24 — 2024-02-11 21:21:15 UTC

Ensuring staff acceptance would occur prior to the "go-live" phase of implementation. With the assistance of the multi-disciplinary support team and a PDSA cycle, real-time solutions will be prepared and implemented as issues arise. Leadership among these disciplines is necessary, as their role is continuous empowerment, education, empathy, etc. Finally, active participation of nursing informatics specialists throughout the process to analyze processes and provide almost immediate solutions and improvements.

Analyzing and refining the workflow

mpike24 — 2024-02-11 21:30:28 UTC

Continued computer simulations: insight into operability and potential workflow disruptions
Data extraction: paired with shared governance approach aids in collection of relevant analytics
Designs Thinking: further information collection
End-user feedback

Conclusion

mpike24 — 2024-02-11 21:31:03 UTC

Focusing on patient-centric scheduling and check-in workflow designs and possible improvements optimizes clinic visits through decreased wait times, thus increasing patient and staff satisfaction. These prominent benefits are just a few of many as incorporation of various approaches like Designs Thinking, only increase efficiency and project success.