Reduction in Clinic Wait Time – Health System Example

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"Reduction in Clinic Wait Time" is an outstanding example of a paper on the health system. Continuous quality improvement in an organization is an essential ingredient in maintaining and sustaining the provision of quality services. It aims at ensuring that services align with the organization’ s mission, values, vision, strategic goals, and objectives intended to be achieved by the organization. Besides, they correspond to regulatory issues and other matters significant to the organization. The quality improvement plan is a proposal idealized in ensuring the quality of services provided by an organization.

Therefore, my proposed quality improvement plan is a reduction in clinic wait times during patient care and management. Current evidence shows that clinic wait time in hospital is costly both to the patient and the hospital ( Morton & Bevan, 2008).   For instance, the vision of Brookwood Medical Center is to create a health care delivery system of value for the 21st century (Brookwood Medical Center, 2002a). It means that reducing clinical wait time would be the right step towards achieving the organization’ s vision. It would ensure a value for the patient’ s time and money.

Moreover, the hospital’ s mission is to provide high quality, cost-effective, and appropriately coordinated delivery of care in targeted service areas (Brookwood Medical Center, 2002a). Clearly, a reduction in clinical wait time would definitely ensure a well-coordinated health care delivery system, high-quality care as well as being cost-effective to both the patient and the hospital. One of the core values of the organization is to foster trust, enhance value, focus on people and change through innovation; therefore, this quality improvement plan pretty much sits well with it. Furthermore, the overall goal and objective of this medical institution relate to its commitment to the provision of quality care (Brookwood Medical Center, 2002a).

And where else does a reduction in clinical wait come in? Nonetheless, nursing regulatory bodies ensure that nursing care is standardized, valuable, efficient, cost-effective, and safe for the patients. Through a reduction in clinical waits, the organization would serve the expectations of relevant regulatory bodies in nursing care. Therefore, this paper will discuss a reduction in clinic wait times as a quality improvement plan, an overview of the current situation, a description of measures and indicators, and a presentation of data related to the plan. Current Situation Current evidence shows that clinic wait time in hospital is costly to the patient and the hospital ( Morton & Bevan, 2008).

Hospitals and other care institutions are grappling with a swelling number of patients either in emergency care or in medical consultancy ( Morton & Bevan, 2008). It is particularly a serious issue in this institution. Morton and Bevarn (2008), observe that there is a role of incentive structure with an economic view that centers on queues as a method of buffering demand.

Although the study focused on a single facility, it was limited to determine variations in performance in other facilities ( Morton & Bevan, 2008). Waiting lists are interpreted as a manifestation of a complex, dynamic and complicated flow of services through an interconnected part of a whole system of care (Rastall & Fashanu, 2001). Siciliani, Stanciole, and Jacobs (2009) grappled with this question, “ Do waiting times reduce hospital costs? ” In concurrence, they agree that indeed waiting times are a major policy issue in most developing countries and even some hospitals in Europe (Siciliani & Stanciole, 2009).

They further opine that waiting time may actually deter patients from asking for treatment. Besides, waiting times may deteriorate the patient’ s health, prolong suffering and potentially generate a loss of utility (Siciliani & Stanciole, 2009). However, waiting times may also reduce idle capacity which confers an efficient use of resources. It probably applies when the demand is stochastic ( Morton & Bevan, 2008). In order for health care organizations to achieve a level above the cost-minimizing point, then there is a need to ration the demand by limiting patients with expected low benefits or dumping them altogether (Siciliani & Stanciole, 2009).

However, it should be tailored carefully as the benefits to the patient may not always be observable to the health care provider. Moreover, ethical issues would emerge as patients have an entitlement to treatment as provided for in National Health Services (Holland, 1997) Rastall and Fashanu (2001), observe that whereas it is unlikely for staff shortage to be addressed adequately, there is a need to review the equity of the current system as chronic patients may be disadvantaged.

Productivity and provision of quality treatment are dependent on the waiting list. They argue the smaller the list, the better the services (Holland, 1997). Measures and Indicators The measures and indicators of this plan would be a progress report from clinicians and other caregivers directly involved in patient care. This would tie improved quality of care to the reduction in clinic wait times. Indicators would be an improvement or a deterioration of a patient’ s condition alongside patient satisfaction levels.

Besides, patient feedback would be invaluable in tracking the quality of care under the new quality improvement plan. Knox and Aspy (2011), concur that challenges in quality are not about the people but the system. Therefore, health care organizations should seek to translate evidence-based research on the effects of a reduction in clinic wait times into practice in order to improve the quality of care. In fact, it is important to put practice into research just as it is important to put research into practice. Additionally, research and evaluation models like Glasgow’ s RE-AIM evaluation conceptual framework help in evaluating the appropriateness of a particular intervention both for clinician’ s practice and patient’ s benefits ( Ernst, et al. , 2009).

Chronic Care Model is another conceptual framework to evaluate the quality improvement plan. It focuses on variables that are directly related to the care of patients. Furthermore, it insists on the separation of the change process from the content of the care process (Dixon-Woods, 2011 ). The target is to realize a reduction in the cost of health care through the introduction of strategies that reduce clinic wait times.

Implementation not only facilitates the translation of knowledge into practice, but also is appropriate for policy (Gardner, et al. , 2011). Presentation of Data The methods, that would be used to collect the data, including questionnaires, interviews, and reviews from the Electrical Medical Records (EMR). The questionnaires will be distributed to patients at random inquiring about their experience under the new quality improvement plan. Patient satisfaction levels would be determined as well. A comparison will be done to the situation prior to the introduction of the intervention.

Interviews will be conducted with both care providers and the patients on their views about the plan and if any changes were observed. Data from the Electrical Medical Records will be analyzed to determine any change in the number of patients attended to under the new plan and its impact. Control charts will be used to analyze the impact of the interventions. Statistical Package for the Social Sciences (SPSS) will be used to analyze EMR data. These methods will be used in the future, about four months after the implementation of the plan. Conclusion In a nutshell, reduction in clinic wait times aligns with Brookwood Medical Center’ s vision, mission, core values, and objectives.

Current evidence shows that clinic wait time in hospital is costly to the patient and the hospital. Measures and indicators of this plan would be progress reports from clinicians, patient feedback, Glasgow’ s RE-AIM evaluation conceptual framework, and the Chronic Care Model. Finally, data collection methods would be by questionnaires, interviews, and EMR while data analysis would be conducted using SPSS and control charts.

References

Brookwood Medical Center. (2002a). Mission Statement. Retrieved from http://www.bwmc.com/en-us/aboutus/pages/missionstatement.aspx

Ernst, M., Wooldridge, J., Conway, E., Dressman, K., Weiland, J., Tucker, K., et al. (2009). Using Quality Improvement Science to Implement a Multidisciplinary Behavioral Intervention Targeting Pediatric Inpatient Airway Clearance. Journal of Pediatric Psychology, 35(1), 15-27.

Morton, A., & Bevan, G. (2008). What’s in a wait? Contrasting management science and economic perspectives on waiting for emergency care. Health Policy, 85, 207–217. doi:10.1016/j.healthpol.2007.07.014.

Dixon-Woods, M. (2011 ). Explaining Michigan: Developing an Ex Post Theory of a Quality Improvement Program. The Milbank Quarterly, 89(2), 167–205.

Gardner, K., Bailie, R., Damin, S., O’Donoghue, L., Kennedy, C., Liddle, H., et al. (2011). Reorienting primary health care for addressing chronic conditions in remote Australia and the South Pacific: Review of evidence and lessons from an innovative quality improvement process. Australian Journal of Rural Health, 19, 111–117.

Holland, K. A. (1997). Does Taking Students Increase Your Waiting Lists? Physiotherapy, 83(4), 166-173.

Knox, L., & Aspy, C. (2011). Quality Improvement as a Tool for Translating Evidence-Based Interventions Into Practice: What the Youth Violence Prevention Community can Learn from Healthcare. American Journal of Community Psychology, 48, 56–64.

Rastall, M., & Fashanu, B. ( 2001). Hospital Physiotherapy Outpatient Department Waiting Lists. Physiotherapy, 87(11), 563-573.

Siciliani, L., & Stanciole, A. (2009). Do waiting times reduce hospital costs? Journal of Health Economics, 28, 771–780, doi:10.1016/j.jhealeco.2009.04.002.

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