Impact of room pooling and electronic health record on patient (pt) wait time, clinic work flow, and pts’/providers’ satisfaction.

Abstract

e18191 Background: Excessive pt wait time can have negative effect on clinic work flow and on pts/ providers satisfaction. Increasing pt volume and limited clinic capacity can lead to long wait times for pts. The purpose of this two-part study was to evaluate the impact of Room Pooling Model (RPM) instead of Room Allocation Model (Part 1) and Electronic Health Record (EHR) on pt wait times in clinic and pts’/providers’ satisfaction (Part 2). Methods: The time studies and pts’/providers’ wait time satisfaction surveys were carried out over 2 weeks before (baseline) and 8 weeks after the implementation of RPM (Part 1), prior to the new EHR system, and 6 months after the implementation of EHR (part 2). All times of when pts, mid-level providers (MLP), and doctors (MDs) entered and exited the exam rooms were collected for 887 pts seen during the clinic. Data was analyzed using JMP and SAS. Results: As described earlier (ASCO 2016, abst 6595), the RPM was associated with increase in the proportion of pts seen by MDs within 30 min from the time roomed in the exam room and improvement in pts’/provider’s satisfaction. Post EHR, there were delays with decrease in the proportion of pts seen within 30 min from the time roomed in. Although the pt satisfaction did not change significantly, the number of times MDs had to wait for an open exam room increased from 8% (5/65) to 24% (14/59, p=0.01). The impact of RPM and EHR on pt times are shown below. The delays to see MDs after EHR were associated with longer time spent with the nurse (from median 4 to 7 min) and delays in seeing MLPs (from 11 to 18 min). Conclusions: These findings indicate that RPM can improve pt wait times. During initial stages of EHR implementation, the increase in pt wait time and reduced clinical efficiencies can be related to learning, and adapting to the new system. These data can be useful to design interventions that can target the areas of delays such as training and redesigning workflow to improve the clinical efficiency. [Table: see text]