Improving patient access at a movement disorder clinic by participating in a Process Improvement Program

Abstract

Our multi-disciplinary neurology team were dissatisfied with long access times for consultation for new referrals. We participated in a rapid process improvement workshop and a structured improvement process. Over a six-month period we were able to reduce our access time for initial appointment for patients with suspected movement disorders from 133 to 20 days. We implemented a ‘carousel’ multi-disciplinary appointment and a standardised clinic form that improved the flow of patients and that we estimate will save 150 hours of physician time and 320 hours of administrative time per year.

Stochastic integer programming for multi-disciplinary outpatient clinic planning

“…Although the implementation of multi-disciplinary systems has frequently been reported in the literature (e.g. [2,[13][14][15]47]), the organization of these multi-disciplinary systems has been underrepresented in the literature [26]. This research focuses on tactical level appointment schedules for multi-disciplinary systems.…”

“…Therefore, the number of overtime patients equals the number of overtime slots, which is equal to the queue length of the last time slot for each clinician type (11). Note that this equation can be replaced with (15) to include multiple clinicians serving overtime patients:…”

“…Multi-disciplinary teams are increasingly being introduced in various medical contexts, such as in outpatient clinics and operating rooms [24,29], and in various medical disciplines, such as cancer care, rehabilitation, and neurology [15,40,47,48]. However, the coordination and control of these teams is complex, as multiple clinicians from multiple departments are involved.…”

Organizing integrated processes in cancer care

“…Therefore, hospitals focus on improvements in patient satisfaction and quality of care [182]. Patient satisfaction is quantitatively measured in terms of access time [113], and waiting and throughput times [14,108,283]. A general pattern is observed that most multi-disciplinary systems in the medical literature are focused towards providing all consultations on a single day.…”

“…As the planning of the drug preparation by the pharmacy and the drug injection by the nurses should be well-coordinated, an integrated perspective is required in planning the chemotherapy appointments [169]. Other examples of multidisciplinary outpatient and day care clinics can be found in cancer diagnostics [108], neurology [113], nuclear medicine [236] and ophthalmology [181].…”