Patient-Flow Analysis for Windows (WinPFA)

[Georges SeuratEtude pour 'Une dimanche à I'lle de la Grande Jatte' (1884)]

Today’s Menu

• Service delivery issues in STD clinics• Questions relating to those issues & WinPFA• WinPFA and its basic premises• Data collection fundamentals • Technical support resources• Workshopping WinPFA

Possible Service Delivery Issues in STD Clinics

• Clinic flow• Appointment system• Staff utilization• Physical plant management • Emergency management• Access• Costs

Related Questions & WinPFAIssue & Questions WinPFA?

Clinic flow •How does client waiting time vary? routine

•What is the mean waiting time between securing an appointment and receiving

services?

difficult

Appointment system •Are walk-ins seen quicker than appointed clients?

easy not routine

•Are appointment “slots” too short, too long?

moderately difficult

Related Questions & WinPFAIssue & Questions WinPFA?

Staff Utilization •Are staff overburdened by paperwork? difficult

•How much staff time is devoted to

translation for other staff? routine

Physical Plant Management •Are waiting room accommodations adequate?

difficult

•Are restrooms and exam rooms cleaned

on a periodic basis? routine

WinPFA’s Critical Characteristics

• Systems’ analysis • Quantify clinic flow• “Prescribed” methodology• No-$$ CDC software • Evaluate existing clinics & plan new

clinics

WinPFA’s Premises:

• Clinic problems: either the systems or people

• Change is quantifiable• Staff know the system• Incremental change works best

The Signature PFA Graph

Planning and Executing a WinPFA Data Collection

• Identify your issues• Identify all flows• Draft, test, & re-test your data collection design • Orient staff and implement D-C• Enter data & generate reports• (Half dozen other implementation steps)

Your Expenditures

• Software• Hardware• Staff training • Learning curve• Data analysis and application

Waiting Time

First Word

“The Cleveland Clinic research… points to four systems factors that stand out in importance for the patient’s point of view:

• Efficient provision of service; • Ability to get appointments quickly; • Time spent waiting for the doctor; • Time spent waiting for tests.”

[Leebov, Patient Satisfaction: A Guide to Practice Enhancement (1990, Medical Economics Company, p.23]

Waiting Time and Client Satisfaction

0

1

2

3

4

5

Likert Scale (0-5)

Waiting Time

StaffPerformanceand OverallSatisfaction

Final Word?

Data to Action

Space utilization• Regularized client-flow allows reduced size

waiting area FTE level• Phlebotomist’s burden results in un-freezing

positions• WIC nutritionist + translator burden justifies

hiring spanish-speaking nutritionistAppointment system re-enforced• Early arriving appointed clients prioritized

after on-time clientsCost reduction• HIV counseling no longer handled by most

medically skilled staff

Your Questions?

Technical Support

• Over-the-phone TA: 770/488-6301 • Questions and listserv

Subscription: WBoyd@cdc.gov or pfa@cdc.gov

• Down-loads: http://www.cdc.gov/reproductivehealth/Products&Pubs/PFA_support/Instructions.htmRequest

• Our list of experienced contractors

Workshopping WinPFA

• Small groups at each laptop• Explore or wait for preceptor • Compare questions and reports• Schedule follow-up for more TA