Patient Flow Analysis

1
Patient FlowAnalysis

• 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
Planning Preparing a PFA

• 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

12
(No Transcript)
13
(No Transcript)
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 PFAOSDH Process

• Morning Briefing
• Pass out Personnel Register Code List
• Distribute Client Registers to Clerical Staff
• Synchronize Time Watches
• Answer Questions

17
Conducting a PFAOSDH 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 PFAOSDH 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 PFAOSDH 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
FormsStaff ID List
22
FormsClient Sign-in Sheet
23
FormsPersonnel Register
24
FormsClientRegister
25
Conducting a PFAEditing 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 PFACommon 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 InterpretationOSDH 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????