Reducing Patient Wait Time Cardiographics Reception Room in the Cardiographics Reception Room Cardiographics Lab

Opportunity Statement & Desired Outcome Patients awaiting testing in the Cardiographics Lab typically had a wait time of over 15 minutes. Factors that influence the ability to move patients into exam rooms include patient arrival time, test recovery times, issues related to equipment use and staff coverage. Goal: To reduce the time between a patient’s scheduled appointment and placement in an exam room to 15 minutes or less for a minimum of 90% of all outpatients.

Identification of Most Likely Causes Most likely causes of increased wait time include: Patients arrive late for their appointments or are detained in other departments Prolonged recovery times for patients already receiving testing and other patient related issues Equipment and space constraints Fluctuations in staffing (e.g., staff vacations, leaves of absence, etc.) Physicians detained and arriving late for testing Difficulty in providing coverage for physicians who are unavailable

Solutions Implemented Improvements were made in education and workflow: The need to promptly escort patients to exam rooms was incorporated into the Cardiographics Service Excellence Program. All staff members are provided with a daily work schedule, so that they can be held accountable for timeliness and efficiency. Electronic documentation of patients arrivals were made the responsibility of the Service Coordinator or her designee. “Add-on” patients are told the approximate amount of time they will have to wait.

Results In November 2002, the percentage of Cardiographics Lab patients brought to an exam room within 15 minutes was 52%. Although we had received no patient complains regarding these wait times, we personally found this unacceptable. Through a series of improvements which are illustrated on the control chart, we were able to increase our 15 minute rooming rate from 52% to 86% within 5 months (by April 2003). This was our most significant improvement. Gradually, over the subsequent 5 months, we were able to attain our target of 90%. We have maintained our goal at or above 90% for all patients roomed within 15 minutes since May 2004.

Next Steps Although a number of “fixes” were implemented, to fully understand all components of the process, there is a need to: A document was created to track specific factors that contribute to Cardiographics Lab rooming delays. Further analysis will be given to those that occur most frequently. Action plans will be developed and implemented to manage all controllable factors.