OUR JOURNEY FROM NEED TO FRUITION

1
OUR JOURNEY FROM NEED TO FRUITION

• Implementing Group Visits for Endoscopy Consults
• Dr. Sean Ebert MD CCFP(anaes)
• Raquel Miles BSN Care North Coordinator
• St. John Hospital Vanderhoof BC

2
PREAMBLE

• Endoscopy service since 1998. Approximately 300
  scopes per year
• Individual consult appointments
• Average wait time for consult 8 weeks
• Average wait time for scope 6-8 weeks
• Procedure appointments booked by hospital staff
  via phone calls

3
OBJECTIVES

• Improve access (decrease waiting time)
• Improve efficiency
• Integrate health services wrap the services
  around the patient
• Improve provider satisfaction
• Improve health outcomes

4
DEFINING THE MEASURES

• TIME 1 referral letter to group visit
• TIME 2 group visit to scope procedure
• Number of patients seen
• Physician and staff work hours

5
PROCEDURE

• Establish the team including hospital staff
• Determine objectives
• Formulate a process
• Set a date, time and location
• Initiated group consults June 25 2008

6
DATA FOR ACCESS
7
DATA FOR HOSPITAL
8
SUMMARY OF MEASURES

• ? TIME 1 to 4 weeks (50 reduction)
• ? TIME 2 to 4 - 6 weeks (30 reduction)
• ? physician consult time by 52
• ? number of patients seen by 29
• ? hospital staff booking time by 64

9
DATA FROM EVALUATIONS
10
HIGHLIGHTS FROM EVALUATIONS

• 79 return rate for evaluations
• 70 of respondents found the group helpful
• 82 of respondents were satisfied overall with
  the group experience

11
COMMENTS FROM EVALUATIONS

• efficiency for the system should reduce the
  cost
• a good use of medical time
• everything done in one day consult and
  booking
• speeds process for everyone. If this is what the
  system needs, then this is great for all!
• others asking questions I wouldnt think of

12
COMMENTS FROM EVALUATION

• not a course of action that is ethically the
  right choice
• what guarantee do I have that people will keep
  what was shared to themselves?
• very uncomfortable in a group with my health
  being discussed
• very strange

13
BARRIERS AND CHALLENGES

• Developing process for booking patients into
  group visits
• Awareness of referring physicians about group
  visits
• Facility to hold group session
• Staff training/office resources clinic overhead
• Setting days and times that were suitable for all
  team members

14
How do we know we have achieved positive
sustainable change?

• Met objectives and measures
• Group visits held twice a month
• Process embedded in the clinic
• Cross-training of clinic staff
• Hospital staff continue to be involved
• Lead physician promoting group visits with other
  physicians
• Patient satisfaction

15
ANECDOTAL IMPROVEMENTS

• OR booking staff believes there are FEWER
  procedure cancellations and preparation errors
  because of face-to-face bookings
• Access for general practice patients has improved
  (wait time reduced from 4-5 weeks to 2-3 weeks)
• Number of referrals increasing

16
THANK YOU FOR ATTENDING OUR PRESENTATION TODAY!

• If you would like more information please do not
  hesitate to contact
• Dr. Sean Ebert spebert _at_telus.net
• Raquel Miles Raquel.Miles _at_northernhealth.ca
• Both Dr. Ebert and Raquel Miles can be reached at
  [phone]