What if you could increase patient volume while reducing your clinical team’s stress, improving professional fulfillment, and enhancing the patient experience?
A researched intervention at a family practice clinic in Michigan found that this may be simpler than you think. The results, published in BMC Res Notes, propose an intervention to enhance healthcare efficiency while achieving healthcare’s Quadruple Aim: reducing costs while improving population health, the patient experience, and team well-being.
Let’s look at how the insights from this research can help your team optimize clinic efficiency while reducing burnout.
Productivity vs. Efficiency
Healthcare faces two seemingly opposed challenges: striving to achieve the Quadruple Aim while increasing productivity.
At first glance, these objectives may seem opposed. Clinicians feel pressured to see more patients while documenting care using suboptimal EHRs. Working harder to increase productivity will cause more work stress and physician burnout, right?
Not necessarily. The key to improving productivity alongside care team well-being lies in clinical efficiency. Here’s how the study authors put it:
“While a productivity focus requires outcomes and puts pressure on individual providers to create results, an efficiency focus is related to process changes and requires organizational change. Thus, theoretically, a focus on efficiency should allow personnel to achieve performance measures while improving workplace well-being since resources and processes are more effective, and team members are working at the top of their license (using the most advanced skills they were trained/educated for).”
In short, don’t put the burden on individual providers to increase patient volume. Instead, healthcare teams should focus on process changes that use the same resources more effectively.
Increase patient volume with the same resources
The 2020 study focused on a Michigan family practice with 25 employees, including six providers. The intervention team comprised one full-time provider, two medical assistants, and one registered nurse. The remaining five providers and their staff continued to see patients as usual.
Researchers hypothesized that a few simple process changes could increase the intervention team’s efficiency while improving all aspects of the Quadruple Aim. They called the intervention EFFECT for “Efficiency-Focused Flow Intervention to Energize Care Teams” (details below).
After two weeks, researchers used team and patient surveys and clinic output data to measure Quadruple Aim outcomes for the intervention and control groups. The results confirmed the hypothesis: the intervention group offered 48% more patient slots than the average reference team and performed better on all Quadruple Aims and productivity measures.
Specifically, the team that made process changes:
- had a slightly higher mean wRVU per visit
- completed significantly more daily HIV screenings than the reference group (researchers used HIV screenings as a proxy for population health procedures administered)
- reported greater professional fulfillment and skills utilization, and lower stress
- received overall more positive patient ratings of both the provider and willingness to recommend the clinic
Healthcare team process changes for greater efficiency
So how did the intervention care team improve all four Quadruple Aims while increasing productivity in just two weeks?
The EFFECT intervention included the following changes, which offer a blueprint for other healthcare teams. In the referenced study, the intervention team:
- Scheduled all visits for 20 minutes instead of 25 minutes and allowed one additional acute visit each hour
- Revised patient flow to allow work task preplanning (staff completed necessary lab draws and vaccinations as part of the intake process)
- Incorporated daily team “huddles” and between-visit “touch-bases” to plan, communicate, and assign responsibilities
- Assigned an MA or RN to scribe and complete all EHR and administrative duties immediately before, during, or after each visit
- Allowed the provider to focus entirely on the patient encounter with no computer-related task.
Changing routine care practices can seem tedious and unimportant when you’re busy at work. But taking the time to coordinate your team and make workflow improvements usually pays off.
The study authors emphasize that their results are preliminary, and they conducted this research with a small sample size. Your primary care clinic may have a different experience with the same intervention. But it also might work.
Putting in the upfront effort to help your team operate more efficiently can produce an enormous return on investment in increasing patient volume and the team’s work satisfaction.
