Patient Cycle Time

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Patient Cycle Time

Observing Patient Cycle Time

Understanding the patient care processes and procedures in your practice, and the impact on the patient flow, will help you to improve the quality of care.

Patient Cycle Time Observation measures the time it takes a patient to move through each part of the visit. The Patient Cycle Time worksheet is data collection sheet for this measure and helps to identify delays in workflows, gaps in the processes and insufficient staffing assignments.

BENEFITS

In the perfect practice, all non-value-added activities would be eliminated and all value-added activities would be balanced to meet practice and customer demands. The ultimate goal is to bump the practice’s value-added time to 80 percent and lower the non-value-added time to 20 percent. Eliminating waste is one of the most effective ways to increase the work flow and profitability of any business. One of the Lean Principles is removing waste. Lean lists eight forms of waste, with the number one form of waste being “Waiting.”

Tracking a patient cycle time helps you to identify:

Bottlenecks or time delays in the patient visit
Inefficient workflows or layouts
Insufficient staffing or scheduling

PATIENT CYCLE TIME TRACKING- Conducted by a practice staff member

Before you get started, communicate to the team, including the physicians, that you are tracking the time the patient spends in the total visit. Explain how the process will look like, and how the information will be used. Be sure the staff understands this is a continuous improvement activity, not an opportunity to point fingers or assign blame.

Explain the workflow – registration, rooming process/flags/lights/boards, and check-out. Select a day or days that represent a typical day in the practice, and all providers are seeing patients. Locate an observation post or posts that will allow you to track the time without interfering with the workflow or altering the existing process. Note the cycle time process will likely be a full day job if only one person is observing.

Using the Patient Cycle Time Worksheet (paper worksheet or Excel worksheet), document the time at each transition or touch point.
E.g. Check-in, rooming/vitals, physician visit, lab/x-ray, nurse/medical assistant, check-out.
Collect data on a sampling of patients across all providers throughout the day.
E.g. 15 patients a day.
If the staff member leaves the exam room and returns, track this time separately.
Round each time period up to the next minute.
If you are tracking manually using the paper worksheet, enter the data from each patient into the Excel form of the Patient Cycle Time Worksheet to generate a report for review. Complete this step at the end of the day of tracking if at all possible while the patients are still fresh in your memory.

PATIENT CYCLE TIME TRACKING - Conducted by a patient

1. Explain to the patient how to use the Patient Cycle Time Worksheet, and what to expect during the tracking process.

2. Encourage to note any additional observations, e.g. materials not available in the exam room.

3. Provide instructions how to document the time spent with the practice staff at each touch point.

4. Verify that the patient has a reliable method for tracking the time, e.g. watch, cell phone, etc.

5. Designate a drop off point for the worksheet.

6. As a thank you, consider some small token of appreciation for those who help collect the data.

While this method would free up time for staff members, the risk of inaccurate tracking increases significantly. You must also consider what this request communicates to your patients – will patients see being part of the process as positive or negative? This will depend on the patients you engage, but be careful not to skew the results through patient selection.