MP58-10 QUALITY IMPROVEMENT INITIATIVE TO OPTIMIZE OUTPATIENT TRIAGE WORKFLOW AND REDUCE BURNOUT

Abstract

You have accessJournal of UrologyHealth Services Research: Quality Improvement & Patient Safety IV (MP58)1 Sep 2021MP58-10 QUALITY IMPROVEMENT INITIATIVE TO OPTIMIZE OUTPATIENT TRIAGE WORKFLOW AND REDUCE BURNOUT Loren Smith, Hannah Moreland, and Timothy Averch Loren SmithLoren Smith More articles by this author , Hannah MorelandHannah Moreland More articles by this author , and Timothy AverchTimothy Averch More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002088.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Our rapidly expanding urology practice increased to eight providers in under two-years’ time with a corresponding growth in patient volume. Triage personnel reported an untenable escalation in workload with mounting burnout representing an opportunity for process improvement. The SMART (specific, measurable, achievable, realistic, timely) aim for this project was to reduce the frequency and duration of triage calls, increase the appropriateness of call content, and improve the well-being of the triage staff. METHODS: Starting September 2020 using Plan-Do-Study-Act (PDSA) quality improvement (QI) methodology, a multiprofessional team iteratively identified systems-level processes available for refinement, leading to optimized triage workflow. Quantitative and qualitative data were obtained sequentially through five phases. Data were collected through a multidisciplinary approach including triage call logs, direct observation, and one-on-one collaboration sessions. Triage personnel were surveyed periodically using an anonymous, validated, repeatable instrument. RESULTS: After five PDSA cycles, triage noted a reduction in call volume by 403 calls (20.3% reduction) with a median call duration of 58 seconds (21.1% reduction), down from a baseline of 1,986 calls with median call duration 73.5 seconds. Restructuring and refinement of the clinical phone tree (PDSA 1-2) and standardized management of non-urgent calls to triage not warranting triage attention (PDSA 3) contributed to the improvement. Notably, five call categories deemed inappropriate for triage were eliminated after the application of PDSA process improvement. Further modifications based on collected survey responses aimed to create a culture of recognition. They included triage interior redesign (PDSA 4), patient paperwork reallocation outside of triage (PDSA 5), and a patient education handout covering a common triage call topic (current PDSA). The latter refinements increased job satisfaction (20%), workload manageability, and fostered greater congruence between job expectations and triage duties. CONCLUSIONS: Small changes to the structure of the work and communication environment resulted in measurable improvements in both call volume and employee satisfaction. Relatively few systems factors were responsible for a majority of triage concerns. Further interventions, including implementing a monthly QI meeting, optimizing use of the patient portal, and improving staffing resource allocation are needed to actualize further employee satisfaction. Source of Funding: N/A © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e992-e992 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Loren Smith More articles by this author Hannah Moreland More articles by this author Timothy Averch More articles by this author Expand All Advertisement Loading ...