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.
Resource Type: 
  • Guide
Topic(s): 

Downloads:

REFERENCES

 

Bodenheimer, T. (2007).  The Teamlet Model of Primary Care.  Annals of Family Medicine. Retrieved from http://www.annfammed.org/content/5/5/457.full

Healthy Huddles.  Center for Excellence in Primary Care.  Retrieved from http://cepc.ucsf.edu/healthy-huddles

Johnson, B. and Stewart, E. (2007, September).  Huddles, Improve Office Efficiency in Mere Minutes.  Retrieved from http://www.aafp.org/fpm/2007/0600/p27.html

Use Regular Huddles and Staff Meetings to Plan Production and to Optimize Team Communication.  Institute for Healthcare Improvement.  Retrieved from http://www.ihi.org/resources/Pages/Changes/UseRegularHuddlesandStaffMeetingstoPlanProductionandtoOptimizeTeamCommunication.aspx

REFERENCES

Introduction

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
  • When group consensus and involvement is necessary​
  • Insufficient staffing or scheduling

PATIENT CYCLE TIME TRACKING:

Conducted by a practice staff member

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.

Record Time

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

Collect data on a sampling of patients across all providers throughout the day.

Continuous Tracking

If the staff member leaves the exam room and returns, track this time separately.

Round Time Period Up

Round each time period up to the next minute.

Enter Data

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

Explain

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

Encourage

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

Provide Instruction

Provide instruction on how to document the time spent with the practice staff at each touch point.

Verify

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

Designate

Designate a drop off point for the worksheet.

Show Appreciation

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.

 
HealthTeamWorks Cycle Time Tracking Tool form with sections to record patient appointment details and timestamps for each stage of a clinical visit.
Cycle Time Tracking Tool for monitoring and improving patient flow in clinical settings.

How Can We Help Your Team Work?