ECG partnered with Bassett Healthcare Network and the Bassett Physician Group to improve physician performance across the primary and specialty services at the group’s flagship medical office building, Bassett Clinic.
Bassett Physician Group, a multispecialty, integrated medical group comprising more than 250 physicians and other doctorates and 150 advanced practice professionals, had implemented several strategies to improve performance. To build upon those initiatives, leadership wanted to further assess operations, productivity, access/service, resource utilization, and other performance determinants in order to identify areas of underperformance and opportunities for improvement. Additionally, management wanted to determine processes and/or functional areas where Lean/Six Sigma process improvement techniques could be incorporated to optimize resource utilization and minimize inefficiency.
ECG was charged with conducting a comprehensive diagnostic review of performance and efficiency at the Bassett Clinic. Upon completion of this assessment, we were asked to develop a prioritized list of specific, implementable recommendations to improve performance across the physician enterprise, as well as within the individual specialty practices.
Our assessment activities included:
- In-depth data analytics of provider schedules, patient appointment information, room utilization, staffing ratios, and access KPIs
- Comprehensive observations across the clinic and in 12 targeted areas, including Women’s Health, the Medicine Clinic, the Surgery Clinic, Prime Care (primary care), Orthopedics, the Scheduling and Call Center, Pediatrics, ENT, Urology, the GI Lab, the Cancer Center, and the Eye Clinic
The assessment of operations revealed three main areas of opportunity to improve performance and enhance efficiency in patient access, the care delivery model, and patient cycle time. With the Surgery Clinic and Prime Care being designated by leadership as high-priority settings, we developed, proposed, and implemented targeted performance improvement solutions for those practices.
The Surgery Clinic: We utilized simulation and optimization-specific software, SIMUL8, to design and refine future-state provider and clinic master schedules in order to identify an optimized work flow platform.
Prime Care: We leveraged Lean tools, such as value-stream mapping, and focused on patient-centered medical home (PCMH) concepts in collaboratively designing and implementing a team-based care model. Subsequently, Bassett Prime Care is preparing to renew its National Committee for Quality Assurance PCMH recognition and further evolve its care delivery model and culture to one that embraces continuous improvement.
The Surgery Clinic: Based on the simulation, we found that existing work flows created inefficiency in the deployment of providers. We tested our recommendations to redistribute clinic sessions across days and modify work flows to increase clinical capacity. The simulation revealed that, without needing to expend additional resources, the Surgery Clinic could expect:
Prime Care: The success of an 8-week pilot program of the redesigned work flows and team-based care model was measured in terms of patient satisfaction, provider satisfaction, third next available appointment, and call abandonment rate. With the implementation of the pilot program, we found that patient and provider satisfaction increased significantly, call abandonment rates fell, and the timeliness of available appointments improved to within 2 days.