Providence Health System - Providence Physician Group, Monroe, WA

Background

Providence Physician Group - Monroe is one of the eight clinics operated by Providence Health and Services, headquartered in Everett Washington. Committed to providing high quality compassionate medical care, Providence Physician Group - Monroe has a dozen providers in family practice, internal medicine and pediatrics.

The Challenge

Dr Deb Nalty, sought out Cech Systems to improve processes in her practice. She worked long hours finishing documentation and patient calls at night and on the weekends, and her production was low relative to her total number of hours at work. Patients were unhappy with delays for services, including long waits in phone queues, long waits to get an appointment (especially for a physical), and long waits in the office when she ran behind schedule. With limited access, her patients were often seen by another provider. Both Dr Nalty and her staff were frustrated with cumbersome work processes and a stressful pace.

Our Solution

We implemented practice improvement solutions to increase patient and referring physician access and improve office flow efficiencies. To improve access, we measured demand and capacity, analyzed patient flow data, introduced new scheduling guidelines and visit increments, opened her template, and worked down appointment backlogs. To streamline patient visits and run on a timelier daily schedule, we facilitated weekly meetings in which physicians, staff and the manager reviewed each process on the visit value stream (e.g., check-in, rooming, ordering other services and exiting the patient) to eliminate waste, clarify care team roles, and appropriately empower the staff to complete their work more easily. We also designed visit increment and processes so Dr. Nalty could complete her documentation at the time of visit, rather than at the end of the day. We provided weekly reports to track the care team progress toward improvement goals.

The Results

Happier Patients	Measure	Family Practice Physician
Better Access	3rd Next Available Physical Appointment	Reduced From 35 Days to 2 Day 94% Improvement
More Efficient Visit	Cycle Time for an Office Visit	Reduced From 30 to 23 Minutes 23% Improvement

Happier Physician and Staff

Physician and staff experienced a higher degree of predictability and consistency in office flow each day.
With increased access, patient wait-time on the phones was significantly reduced, and staff satisfaction with the scheduling process was significantly improved. The "morning chaos" of patients vying for the same few appointments was eliminated.
Dr. Nalty went home earlier and had a greater sense of completion at the end of the day, while at the same time improving her production.
Cancellation/no show rate reduced by 34%.

Improved Bottom line	Measure	Family Practice Physician
Increased productivity	Increase in Monthly Professional Production Pre vs. Post Implementation	24% Improvement