Increasing Workflow Efficiency in Urology Procedure Clinic

Abstract

INTRODUCTION: Workflow inefficiency for urologic procedures leads to wasted time and workplace dissatisfaction, resulting in lost revenue due to low procedure volume and high staff turnover. We hypothesized that for staff (nurses/medical assistants) and patient teams, team workflow duration, the time required to complete team duties for a single appointment, could be reduced by 50% with a targeted workflow intervention developed using the Model for Improvement and Plan-Do-Study-Act (PDSA) cycles. METHODS: A baseline time study was performed to measure team workflow duration for all procedure appointment teams, including the front desk, physician, staff, and patient teams. Implementation of previously identified interventions was also recorded. A workflow intervention was developed in which staff duties were split among 2 overlapping roles: staffer and triager. Team workflow duration and intervention implementation were re-measured during 8 PDSA cycles. Semistructured 1-on-1 interviews were conducted as a balance measure to assess impact on staff workflow and wellness. RESULTS: Our workflow intervention resulted in a 44% and 42% reduction in staff and patient team workflow durations, saving nearly 17 minutes per appointment on average (Figure). Thematic analysis revealed that time saved would be best used to support staff wellness, such as protecting lunch breaks and allowing time to complete nonclinical duties such as patient calls, which had previously been performed after hours. CONCLUSION: Introduction of staffer and triager roles to staff workflow increased clinic efficiency by reducing team workflow and procedure appointment duration. Time saved can be used to increase procedure volume while also supporting staff wellness.Figure