Assessing Unwanted Variations in Rheumatology Clinic Previsit Rooming.
J Clin Rheumatol
; 25(3): e1-e7, 2019 Apr.
Article
em En
| MEDLINE
| ID: mdl-29757802
ABSTRACT
BACKGROUND:
Rheumatologists face time pressures similar to primary care but have not generally benefitted from optimized team-based rooming during the time from the waiting room until the rheumatologist enters the room.OBJECTIVE:
The aim of this study was to assess current capacity for population management in rheumatology clinics; we aimed to measure the tasks performed by rheumatology clinic staff (medical assistants or nurses) during rooming.METHODS:
We performed a cross-sectional time-study and work-system analysis to measure rooming workflows at 3 rheumatology clinics in an academic multispecialty practice during 2014-2015. We calculated descriptive statistics and compared frequencies and durations using Fisher exact test and analysis of variance.RESULTS:
Observing 190 rheumatology clinic previsit rooming sequences (1419 minutes), we found many significant variations. Total rooming duration varied by clinic (median, 6.75-8.25 minutes; p < 0.001). Vital sign measurement and medication reconciliation accounted for more than half of rooming duration. Among 3 clinics, two of 15 tasks varied significantly in duration, and 9 varied in frequency. Findings led clinic leaders to modify policies and procedures regarding 6 high-variation tasks streamlining assessment of weight, height, pain scores, tobacco use, disease activity, and refill needs.CONCLUSIONS:
Assessing rheumatology rooming tasks identified key opportunities to improve quality and efficiency without burdening providers. This project demonstrated user-friendly methods to identify opportunities to standardize rooming and support data-driven decisions regarding rheumatology clinic practice changes to improve population management in rheumatology.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Assistentes Médicos
/
Reumatologia
/
Administração de Instituições de Saúde
/
Assistência Ambulatorial
/
Instituições de Assistência Ambulatorial
/
Enfermeiros Clínicos
Tipo de estudo:
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
J Clin Rheumatol
Assunto da revista:
FISIOLOGIA
/
ORTOPEDIA
/
REUMATOLOGIA
Ano de publicação:
2019
Tipo de documento:
Article