Quality Improvement In Cf Clinic: Patient Downtime And Clinic Workflow
BACKGROUND: In July 2018 a quality improvement (QI) Cystic Fibrosis (CF) Foundation grant, FUN to OneCF, LLC, was awarded to improve overall QI process through QI instrument education and live coaching. The global aim was to improve CF Center organization. In late 2018 Patient Care Satisfaction surveys were sent to Cystic Fibrosis (CF) adult patients and caregivers of child patients. The highest frequency complaint was time in CF Clinic appointment, in particular, downtime without a clinical team member in the appointment.
SPECIFIC AIM: To assess and reduce the overall length of appointments while maintaining quality multidisciplinary care, the aim of decreasing downtime from 45 minutes to 30 minutes by October 2018 was established.
METHODS: Time Cycles in the clinic were collected. The average downtime was 45 minutes. Clinic process flow, resources needed, communication challenges and brainstorming were used to develop Plan-Do-Study-Act (PDSA) cycles.
PDSA #1: Pre-visit planning
PDSA#2: Pre-visit call
PDSA #3 implementation of a "closer"
RESULTS: The goal of 30 minutes downtime was exceeded, averaging downtimes of 20-30 minutes. Patients indicate they appreciate the QI efforts, decreased downtime and decreased length of appointments.
Conclusions: Participation in the collaborative and live coaching improved communication among CF Clinic team members. Use of QI tools and regular coaching improved clinic visit downtime and overall clinic flow.