RESUMO
OBJECTIVE: The purpose of this study was to implement a 2-phase approach to rapidly increase the number of annual wellness visits (AWVs) and build a sustainable model at 3 study units (Mayo Clinic in Rochester, Minnesota, and clinics in 2 regions of Mayo Clinic Health System), which collectively serve approximately 80 000 patients who qualify for an AWV annually. METHODS: In the rapid improvement phase, beginning in July 2022, goals at the facilities were reoriented to prioritize AWVs, educate staff on existing AWV resources, and create low-effort workflows so that AWVs could be incorporated into existing patient appointments. Staff at all 3 study units worked independently and iterated quickly. In the second phase, all study units collaborated to design and implement a best-practice solution while they leveraged the engagement and lessons learned from the first phase and invested in additional system elements and change management to codify long-term success. RESULTS: The number of AWVs completed monthly increased in each study unit. In the rapid improvement phase, the number of AWVs increased but then plateaued (or decreased at some study units). In April 2023, the final scheduled outreach automation and visit tools were implemented, and the number of AWVs was sustained or increased, while outreach and scheduling times were decreased. The number of completed AWVs increased from 1148 across all study units in the first 6 months of 2022 to 14 061 during the first 6 months of 2023. CONCLUSIONS: The lessons learned from this project can be applied to other health systems that want to provide more patients with AWVs while improving operational efficiency. The keys are to have a clear vision of a successful outcome, engage all stakeholders, and iterate quickly to find what works best for the organization.
Assuntos
Promoção da Saúde , Humanos , Minnesota , Promoção da Saúde/métodos , Melhoria de Qualidade , Atenção Primária à Saúde/organização & administração , Agendamento de ConsultasRESUMO
Ambulatory staffing to workload based on visit volume in an outpatient setting is an elusive formula, and the literature describing such processes is limited. One health system tasked a multidisciplinary team with developing an ambulatory staffing to workload tool to meet the needs of staff, management, and leadership. The resultant tool includes an automated dashboard for determining staffing needs on the basis of quantified workload, prospective modeling, and historical dashboards to demonstrate actual staffing (full-time equivalents) to workload (outpatient volumes) compared with budget.