Patient FlowPatient FlowAnalysisAnalysis

Oklahoma State Department of Health

Miriam McGaugh, MS

Patrick Hattaway

OSDH PFA TeamOSDH PFA Team

• Miriam McGaugh• Patrick Hattaway• Thad Burke• Lynn Madsen

• Ann Benson• Cari Thompson• Susan Boyd• Amy Morse – OSU

Intern

What is Patient Flow Analysis?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)

Benefits of PFABenefits 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

Process of PFAProcess of PFA

• Planning & Preparing

• Data Collection

• Data Entry

• Data Analysis and Interpretation

Forms Used in a PFAForms Used in a PFA

• Staff ID List - SID

• Client Sign-in Sheet - CSS

• Personnel Register - PR

• OSDH Code List - CL

• Client Register - CR

Optional Documents for PFAOptional Documents for PFA

• Personnel List with salary information

• Clinic Appointment Roster by Date

• Master Schedule Report

• Attended Appointment Summary

Planning & Preparing Planning & Preparing a PFAa PFA

Planning & Preparing a PFAPlanning & 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

Planning & Preparing a PFAPlanning & 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?

Planning & Preparing a PFAPlanning & Preparing a PFA

• Study Variable Codes– OSDH Code List (CL)

• Clinic Tasks

• Reason For Visit

• Appointment Type

– County specific codes

Planning & Preparing a PFAPlanning & 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

Conducting Conducting a PFAa PFA

Conducting a PFAConducting a PFAOSDH ProcessOSDH Process

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

Conducting a PFAConducting a PFAOSDH Process – Client Sign-inOSDH 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

Conducting a PFAConducting a PFAOSDH Process – Client TrackingOSDH 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

Conducting a PFAConducting a PFAOSDH Process – PersonnelOSDH 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.

Conducting a PFAConducting a PFA

Forms

FormsFormsStaff ID ListStaff ID List

Staff ID List County: _____________________________ Date:___________________

Each staff member involved in the clinic has been assigned a specific code to be used when documenting activities on either the personnel or client registers. The code is 2 characters. You will use this code throughout this study. At the time of data entry additional characters may be added to your specific code if you perform more than one primary task in this clinic. This will allow for more appropriate evaluation of clinic flow on this date. Detailed information will be provided when the reports are submitted.

Employee Id LNAME FNAME MI Classification

FormsFormsClient Sign-in SheetClient Sign-in Sheet

FormsFormsPersonnel Personnel RegisterRegister

FormsFormsClientClient

RegisterRegister

Conducting a PFAConducting a PFAEditing DataEditing 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

Conducting a PFAConducting a PFACommon ErrorsCommon 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

Wrapping Up a PFAWrapping Up a PFA

Data Entry, Analysis & Data Entry, Analysis & InterpretationInterpretation

OSDH ProcessOSDH 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

Questions????Questions????