Practice tab

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Respect for patients' values, preferences, and expressed needs

Coordination and integration of care

Information and education

physical comfort

Emotional support and alleviation of fear and anxicty

Involvement of family and friends

Transition and continuity

Access to care

performance Data

The last quarter's worth of performance data for Clinic $x$ are the following:

overall satisfaction with visit rated as very good or excellent

Staff courtesy and helpfulness rated as very good or excellent Waiting room time for patients is less than $15$ minutes

$82\%$

$90\%$

$64\%$

Examination room waiting time is less than $15$ minutes

$63\%$

patient no$-$show rate

$20\%$

patient appointment cancellation rate

$11\%$

Provider appointment cancellation rate $10\%$

Rate of initial insurance claim rejections because of inaccurate or $4\%$ incomplete patient record documentation

$16\%$

patient preregistration rate

$16$

Average number of patient visits per day

$10-23$

Range of patient visits per day

$10-23$

Instructions $($continued$)$

$3.$ Before continuing, completely read all of the remaining instructions,

$4.$ Decide which problem you want to focus on as your first priority for Clinic X$.$

Describe the problem and why you chose this problem.

$5$ State the goal for the improvement effort.

$6$ Identify the fundamental knowledge required by the improvement project team to solve this problem. Identify the people $($professional group or service area$)$ that should be represented on the team and the fundamental knowledge they bring to the team.

$6$Document the current process $($as it is described in the case narrative$)$ using a process flowchart.

$8$Identify the customers of the process to be improved and their expectations.

$9$Explore and prioritize root causes of the problem by doing the following:

a$.$ Brainstorm root causes and document the causes on a fishbone diagram.

b$.$ Describe how you would collect data about how frequently the root

Practice tab

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$3.$ Eliminate waste $($e$.$g$.,$ things that are not $6$ through $8.$ unnecessary duplication$)$ not used, intermediaries,

b$.$ Improve workflow $($e$.$g$.,$ minimize handoffs, move steps in the process closer together, find and remove bottlenecks, do tasks in parallel, adjust to high and low volumes$)$

c$.$ Manage time $($e$.$g$.,$ reduce setup time and waiting time$)$

d$.$ Manage variation $($create standard processes where appropriate$)$

e$.$ Design systems to avoid mistakes $($use reminders$)$

$11.$ Incorporating what you learned in steps $6$ through $9,$ describe the changed process using a process flowchart or workflow diagram.causes contribute to the problem.

Decide what you will measure to monitor process performance to be sure your changes were effective and briefly describe how you would collect the data.

You have completed the "Plan" phase of the Shewhart cycle. Describe briefly how you would complete the rest of the Plan, Do$,$ Check, Act cycle.

Save your answers to each part of this exercise. This material will become the documentation of your improvement effort.