Data-Driven Scheduling for Improving Patient Efficiency in Ophthalmology Clinics.
Ophthalmology
; 126(3): 347-354, 2019 03.
Article
em En
| MEDLINE
| ID: mdl-30312629
ABSTRACT
PURPOSE:
To improve clinic efficiency through development of an ophthalmology scheduling template developed using simulation models and electronic health record (EHR) data.DESIGN:
We created a computer simulation model of 1 pediatric ophthalmologist's clinic using EHR timestamp data, which was used to develop a scheduling template based on appointment length (short, medium, or long). We assessed its impact on clinic efficiency after implementation in the practices of 5 different pediatric ophthalmologists.PARTICIPANTS:
We observed and timed patient appointments in person (n = 120) and collected EHR timestamps for 2 years of appointments (n = 650). We calculated efficiency measures for 172 clinic sessions before implementation vs. 119 clinic sessions after implementation.METHODS:
We validated clinic workflow timings calculated from EHR timestamps and the simulation models based on them with observed timings. From simulation tests, we developed a new scheduling template and evaluated it with efficiency metrics before vs. after implementation. MAIN OUTCOMEMEASURES:
Measurements of clinical efficiency (mean clinic volume, patient wait time, examination time, and clinic length).RESULTS:
Mean physician examination time calculated from EHR timestamps was 13.8±8.2 minutes and was not statistically different from mean physician examination time from in-person observation (13.3±7.3 minutes; P = 0.7), suggesting that EHR timestamps are accurate. Mean patient wait time for the simulation model (31.2±10.9 minutes) was not statistically different from the observed mean patient wait times (32.6±25.3 minutes; P = 0.9), suggesting that simulation models are accurate. After implementation of the new scheduling template, all 5 pediatric ophthalmologists showed statistically significant improvements in clinic volume (mean increase of 1-3 patients/session; P ≤ 0.05 for 2 providers; P ≤ 0.008 for 3 providers), whereas 4 of 5 had improvements in mean patient wait time (average improvements of 3-4 minutes/patient; statistically significant for 2 providers, P ≤ 0.008). All of the ophthalmologists' examination times remained the same before and after implementation.CONCLUSIONS:
Simulation models based on big data from EHRs can test clinic changes before real-life implementation. A scheduling template using predicted appointment length improves clinic efficiency and may generalize to other clinics. Electronic health records have potential to become tools for supporting clinic operations improvement.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Visita a Consultório Médico
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Oftalmologia
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Agendamento de Consultas
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Eficiência Organizacional
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Centros Médicos Acadêmicos
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Registros Eletrônicos de Saúde
Tipo de estudo:
Prognostic_studies
Limite:
Adolescent
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Child
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Child, preschool
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Humans
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Infant
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Newborn
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article