Integrating Patient Education Into the Glaucoma Clinical Encounter: A Lean Analysis.
Newman-Casey Paula A, Musser John A, Niziol Leslie M, Heisler Michele M, Kamat Shivani S, Shah Manjool M, Patel Nish, Cohn Amy M
AI Summary
Glaucoma clinic wait times are substantial, offering ample opportunity to integrate crucial patient education, like eye drop instillation, into the existing visit structure.
Abstract
Purpose
The main purpose of this study was to use Lean analysis to identify how often and when wait times occur during a glaucoma visit to identify opportunities for additional patient engagement.
Methods
This prospective observational time-motion study measured process and wait times for 77 patient visits from 12 ophthalmologists at an academic glaucoma clinic over a 3-month period. Value stream maps visually diagramed the process of a clinical visit from the patient's perspective. Descriptive statistics were calculated for process times, wait times, and the frequency of 10+ minute wait times during each part of the visit. Key stakeholders participated in a root cause analysis to identify reasons for long wait times. The main outcome measure was average times (hours: minutes: seconds) for process times and wait times.
Results
Twenty-nine new visit (NV) patients and 48 return visit (RV) patients were included. Total time in clinic was 187.1±44.5 (mean±SD) minutes for NV patients and 102.0±44.7 minutes for RV patients. Wait time for NV patients was 63.7±33.4 minutes (33.1% of total appointment time) and for RV patients was 52.6±31.6 minutes (49.4% of the total appointment time). All NV patients and 87.5% of RV patients had at least one 10+ minute wait time during their clinic visit and the majority (75.9% NV, 60.4% RV) had >1.
Conclusions
Currently, sufficient wait time exists during the visit for key portions of glaucoma education such as teaching eye drop instillation.
MeSH Terms
Shields Classification
Key Concepts6
All new visit (NV) glaucoma patients and 87.5% of return visit (RV) glaucoma patients experienced at least one wait time of 10 minutes or longer during their clinic visit.
The majority of new visit (NV) glaucoma patients (75.9%) and return visit (RV) glaucoma patients (60.4%) had more than one wait time of 10 minutes or longer during their clinic visit.
Sufficient wait time exists during glaucoma patient visits for key portions of glaucoma education, such as teaching eye drop instillation.
The total time in clinic for new visit (NV) glaucoma patients was 187.1 ± 44.5 minutes (mean ± SD), and for return visit (RV) glaucoma patients, it was 102.0 ± 44.7 minutes.
Wait time for new visit (NV) glaucoma patients was 63.7 ± 33.4 minutes, accounting for 33.1% of their total appointment time.
Wait time for return visit (RV) glaucoma patients was 52.6 ± 31.6 minutes, comprising 49.4% of their total appointment time.
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