Reference no: EM132675528

CASE STUDY - MIDDLE BEACH MEDICAL CLINIC

Middle Beach Medical Clinic is a busy clinic located in an inner suburb of capital city. The centre is owned by five doctors but there are twelve other doctors employed. Some doctors are full time while others are part time. All the doctors' hours vary as the clinic is opened seven days a week, Monday to Friday 7.30 am - 8.00 pm and Saturday and Sunday 8.00 am - 12.00 pm.

The clinic also employs an Practice Manager, five receptionists/office administrators and three part time nurses.

Most doctors specialise in specific areas of medicine. Some patients consistently see the same doctor but many patients change from doctor to doctor based on their requirement for a speciality in medicine and doctor availability.

The clinic is always busy but at times it can become hectic as up to eight doctors are simultaneously seeing patients during the clinic's peak times. The reception desk becomes congested as reception staff are taking calls to book appointments, take messages or transfer calls, greeting patients, checking appointments, making new appointments and processing accounts. On occasions there have been disputes as patients feel that they are not being attended to in turn.

When doctors are running late, the waiting room overfills and patients are sometimes forced to stand or to wait outside in a courtyard area. A café is located a few doors away and some patients like to spend waiting time here. This causes problems as patients are recorded as having arrived but staff are unable to locate them when it is their turn to be seen by the doctor.

The clinic is experiencing problems at the reception area that needs addressing. Patients are sometimes overlooked upon arrival and doctors are not aware that they have arrived resulting in appointment slots being missed. Patients also become frustrated and angry when waiting times extend up to one hour. Confusion sometimes arises as patients are unsure as to which doctor they are booked in to see. Staff cannot always easily locate patients when they are ready to be seen by the doctor. The reception area is crowded and reading materials are limited. The clinic is very proactive about cross infection. Daily newspapers are provided but magazines and toys are considered a potential source of infection.

The clinic is wanting to make the following improvements to the way the reception area is managed and have requested you to assist with this task.

· Greeting patients and noting their arrival

· Reducing confusion of which doctor patients are seeing

· Reducing waiting times or notifying patients before they arrive that appointments are running late

· Ensuring patients are ready to see the Doctor when called

· Reducing crowding of reception area

· Providing materials to engage patients while they are waiting for their appointment (mindful of infection)

You have decided the Deming Cycle or PDSA would work well for trialling and implementation of your suggested improvements.

1. How Develop a plan to rectify the following problems in the management of the reception area and Explain the ideas under each heading:

a. Greeting patients and noting their arrival

Write the suggestions here eg Upon arrival signs and a roped off area direct you towards reception staff who greet, acknowledge your arrival and direct you to a seating area

b. Reducing confusion of which doctor patients are seeing

Upon booking, patients receive a SMS with details of appointment

c. Reducing waiting times or notifying patients before they arrive that appointments are running late

If appointments are running more than 30 minutes late, patients will receive a text message advising them of a delay and option to re book appointment

d. Ensuring patients are ready to see the Doctor when called

Each patient are allocated a number which is displayed on the board

e. Reducing crowding of reception area

A garden area with seating acts as a waiting area overflow

f. Providing materials to engage patients while they are waiting for their appointment (mindful of infection)

Patients are provided with an IPad to listen to podcasts

2. How to prepare or make a presentation to be viewed by staff that includes:

a. A brief explanation of the benefits of implementing continuous improvement processes

b. Strategies to encourage staff to become involved, to take initiative and to participate in the planning, decision making and implementation of the improvements

c. A plan of how to mentor and coach the staff in continuous improvement

d. The ideas to improve the management of the reception area (as answered in Question 1 a - f)

3. i. how you will communicate and gain support for continuous improvement?

ii. how it will be implemented into the organisation, suggest methods to collect feedback from internal and external customers. Suggest communication strategies eg staff training on the benefits of continuous improvement and . A great way of generating support for change into an organisation is appointing a champion eg a Quality or Continuous Improvement Champion (or a diversity champion or an OH&S champion etc)

Feedback can be collected from internal stakeholders by including an agenda item for suggestions when staff meetings are conducted. Feedback can be collected from external stakeholders such as patients using suggestion boxes.

4. i. With Using systems and technology at the organisation, determine, how you will monitor and review progress of the planned changes ie is the new system working?

ii. What to create ways of comparing before and after etc.Collect statistics, create charts,

-What systems do you suggest? Technology can be just simple computer packages?

5. i. WHat the Identify four ways how your suggested continuous improvement initiatives at the reception (Q 1 a - f) area will improve services to internal and external customers.

ii What benefits has continuous improvements provided eg less error. For each point do not just identify (eg less errors), explain how eg by introducing a greeting procedure to patients as they arrive whereby they have to have their name marked off there will be less errors that result in patients being overlooked and missing their appointment as staff have not indicated that they have arrived and are waiting to see the doctor?

6. i. What Based on your feedback received from patients/customer?

iii. how to prepare or make a communication plan of the recommended changes to the original plan?

iv. What Determine how you will communicate any adjustments to your plan (the Act stage).

iii. Identify several methods of communication eg face to face meeting, email then a FAQ section on the intranet. If a suggestion for improvement has been made and then the clinic decides to implement this idea, how are they going to communicate this to all staff eg our original plan was this but now we are going to ........ It is always a good idea to use several methods of communication to ensure that staff do not miss any crucial information.

7. i. What the Identify three ways to inform staff on the progress of the service improvements in the reception area?

ii. How are staff going to be kept in the loop as improvements are being made. Your ideas for this answer can be similar to your answer to question 6. This question is more of an ongoing situation?

8. i. What the Identify three ways document work performance to identify problems that require action.

ii. What the Suggest methods to document problems or suggestions as they are identified eg you may introduce a live document that staff can access and input a problem or an improvement that could be made that they are experiencing that they feel should be enacted upon?

9. How to Develop a procedure to manage records, reports and recommendations ie capture, review, actioned, stored, accessed.