1. Patient Flow Analysis Oklahoma State Department of Health Miriam McGaugh, MS Patrick Hattaway

2. OSDH PFA Team Miriam McGaugh Patrick Hattaway Thad Burke Lynn Madsen Ann Benson Cari Thompson Susan Boyd Amy Morse – OSU Intern

3. What is Patient Flow Analysis? A process that tracks patient flow and use of personnel time in clinic settings Used to… –Identify problems in flow –Identify personnel needs –Identify space needs –Track personnel costs (if included)

4. Benefits of PFA To Staff/ Personnel –Ability to respond to staff/personnel concerns –Better understanding of roles and needs of different departments –Increases information available to managers To Customer –Refocuses on customers –Improved continuity of care To Clinic –Team-building tool –Greater communication

5. Process of PFA Planning & Preparing Data Collection Data Entry Data Analysis and Interpretation

6. Forms Used in a PFA Staff ID List - SID Client Sign-in Sheet - CSS Personnel Register - PR OSDH Code List - CL Client Register - CR

7. Optional Documents for PFA Personnel List with salary information Clinic Appointment Roster by Date Master Schedule Report Attended Appointment Summary

8. Planning & Preparing a PFA

9. Study Coordinator –Unbiased and receptive to needs and ideas Management –Commit to process and assure communication PFA Team –Admin. Dir, DNM, Coordinating Nurse, APO/AA, Records Cons., others

10. Planning & Preparing a PFA When and how will clients be entered on the sign- in sheet? Who will distribute the CRs? How will the CRs be routed through the clinic? Which staff persons will determine the Reason for Visit and Sub-classification? When will staff persons receive their PRs? How will the CRs and the PRs be collected? What method of synchronizing time will be used? What other information should be collected specific to the study?

11. Planning & Preparing a PFA Study Variable Codes –OSDH Code List (CL) Clinic Tasks Reason For Visit Appointment Type –County specific codes

14. Planning & Preparing a PFA CHD Meeting –Communicate plan to staff prior to collection –Emphasize purpose is to improve clinic efficiency and NOT to evaluate individual staff performance –Answer questions –Informational session –Repeated day before or day of data collection

15. Conducting a PFA

16. Conducting a PFA OSDH Process Morning Briefing –Pass out Personnel Register & Code List –Distribute Client Registers to Clerical Staff –Synchronize Time & Watches –Answer Questions

17. Conducting a PFA OSDH Process – Client Sign-in Fill out county, date, time and ID# Hand to patient for them to complete name (optional) They take to clerical staff for regular check- in process

18. Conducting a PFA OSDH Process – Client Tracking CSS is stapled to back of CR Clerical staff fills out top of CR (except TOD) CR is placed on front of chart for rest of visit All client contact is tracked CR is sent (with BCD) with client for checkout

19. Conducting a PFA OSDH Process – Personnel Staff ID pre-assigned based on Staff ID List All personnel involved with clients on day of clinic Include travel only if PFA site is not home duty station. Personnel will track all times throughout day Record if unavailable/no-contact for more than 10 minute block.

20. Conducting a PFA Forms

21. Forms Staff ID List

22. Forms Client Sign-in Sheet

23. Forms Personnel Register

24. Forms Client Register

25. Conducting a PFA Editing Data Ensure that all required fields are complete Clear and legible Personnel Registers –Time in and out completed on all forms –Staff ID code matches Staff ID List Client Registers –All contacts: Staff ID, Task code, Time In & Out –Chronological Order Client Sign-in Sheet attached to Client Register

26. Conducting a PFA Common Errors Missing or Incorrect Break Times (PR) Missing Time of Arrival or Time of Appointment (CR) Time of Arrival later than first contact Start Time (CR) Missing Client or Staff ID code

27. Wrapping Up a PFA

28. Data Entry, Analysis & Interpretation OSDH Process All forms will be sent to OSDH staff Entered into WinPFA 2.1 Reports generated by clinic Statistical analysis completed for all clinics combined See PFA User Guide Optional Modules

29. Questions????