In 2017, the flagship multispecialty practice of Oregon Medical Group, moved into its new digs — a 46,000 square foot redesigned medical office building. Practice leaders and the 30-odd clinicians in six different specialties were committed to a coordinated patient experience. They wanted to ensure that patients could move smoothly between sequential visits with different care providers — on the same day. To this end, the group invested in a centralized check-in process. However, the spacious physical plant was a significant obstacle to a smooth, efficient patient flow, even with centralized check-in.
I spoke with two leaders of the group, Chief Executive Officer Karen Weiner, MD, MMM, and Chief Operating Officer Eve Riley, MSN, MHA, about the innovative solution the practice is using to address this challenge: self-rooming using real-time location system (RTLS) technology.
At the centralized check-in area on the first floor, patients are given an electronic badge and a laminated card with a map and assigned an exam room. They proceed directly to the exam room, where they are met by a medical assistant (MA), thus, spending no time in crowded, potentially infectious waiting rooms. The MA prepares the patient for the clinician and enters information into the electronic health record. The clinician sees the patient, and then the MA directs him or her to the next appointment or to the exit.
All along the way, the patient is tracked via the electronic badge, which activates sensors located throughout the building. Staff can check their workstation monitors to see the status of any patient (waiting in room, with MA, with a clinician, waiting for discharge) and any exam room (occupied, needs to be cleaned, ready for a patient). Staff can also easily locate clinicians to coordinate activities with them.
The group started its pilot project with one physician in September 2017. The process was quickly spread to the entire interventional pain management department. Now, according to Riley, staff members in other departments are requesting that self-rooming be used throughout the practice. “We were surprised by the staff response. We didn’t expect staff to love it. We thought it would be a push process, where we would have to place a great deal of effort to generate buy-in, but instead, it’s been a pull.” Once self-rooming is in place throughout the entire practice, the process will be used to coordinate care between departments, allowing patients to experience smooth travels between several appointments, such as orthopedics, imaging, and physical therapy, all on the same day.
Why is the staff so enthused? Medical assistants and front office staff had this to say about the change:
- “[I am] spending less time bouncing between floors – going from 23,000 steps a day with traditional rooming, down to 9,000 steps a day with patient self-rooming.”
- “Patients are waiting less and feel like we are really taking care of them.”
- “My physician isn’t waiting for a patient or waiting for discharges, and they are spending more time with their patients.”
- “The efficiency it has created from the traditional way we roomed – it has improved our efficiency two-fold.”
Hard data that the group shared with me are equally impressive:
- 75% reduction in patient wait time prior to being seen by a clinician
- 50% reduction in time spent waiting in the exam room for the physician
- 60% reduction in the number of steps taken by medical assistants daily
- 50% increase in time spent with medical assistant
- Time spent with physician increased by 5 minutes per patient
Because travel time and delays have been reduced, clinicians now have 5 additional minutes per patient in their schedule, which they can spend in longer visits, documenting care, or seeing an additional two patients per day.
What began as a challenge — helping patients easily navigate a multispecialty practice in a large space — led to an inspired innovation that blends process improvement with new technology to optimize the care experience for patients, staff, and clinicians.
Diane W. Shannon is an internal medicine physician who blogs at Shannon Healthcare Communications.
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