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8/3/2019 Elam-Miller Day 2 Breakout 1130 Am-R
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Phoenix, AZ
September 20, 2006
Presented by:Anne Elam, RN, MPH,
VA Department of Health
Shelley Miller, MS,
TRAINING 3, Family Planning Council,Philadelphia, PA
Patient Flow Analysis: A
Comprehensive Approach toTraining of Title X Staff in Virginia
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Brief History
VA Dept. of Health had used PFA (DOS) inthe past, early 1990s, with success
Patient Flow Analysis focuses on clinicefficiency and improvement
Time to re-evaluate clinical settings supported by site visit by OPA
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Issues we hoped to Explore:
Clinic Waiting Time
Utilization of Staff Flow of Services
Secondary By-product: Greater Staff Satisfaction
Decrease Patient Frustration
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Overview of the Process
At the request of VA Department of Health, Title X grantee,TRAINING 3 contracted with PFA consultant, Brian Senecal, todevelop comprehensive plan to train providers throughout VAon the utilization of Win PFA
TRAINING 3 completed one on-site comprehensive WinPFAwith the Petersburg health center in VA Feb/March 2005
The materials from this study were used throughout thetrainings that followed
The first Training of Providers (TOP!) was
delivered: Part 1 - March/Part 2 - April 2005
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Train the ProvidersPart 1
The first 2-daytraining was heldin a computer lab(local community
colleges providedlow cost andquality facilities)
http://images.google.com/imgres?imgurl=http://www.twu.edu/is/images/Presby%2520Computer%2520Lab.jpg&imgrefurl=http://www.twu.edu/is/PresbyterianCampus_classroomlabs_descriptions.htm&h=300&w=400&sz=33&hl=en&start=1&tbnid=jiKeMEVytrfg1M:&tbnh=93&tbnw=124&prev=/images%3Fq%3Dcomputer%2Blab%26svnum%3D10%26hl%3Den%26lr%3D8/3/2019 Elam-Miller Day 2 Breakout 1130 Am-R
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Train the ProvidersPart 1
Design of thetraining
included: History of PFA and Whydo PFA
Purpose of PFA: What itDoes & Does Not Do
PFA Output: Review ofreports of graphs
Overview of the PFAprocess
Hands on skills
Review & developmentof forms
Data collection
Visual edits
Data entry
Producing Reports &
Graphs Preparing for the
orientation and study
Conducting the study
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What PFA Does Do
Identifies show rate
Client time in the clinic and with staff
Waiting time between stops (bottlenecks) Lost clients
Staff time available and service time
Time clients spend at each stop Personnel costs
Visit types
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What PFA Does Not Do
Determine solutions
What staff and clients were doing
during contact time If personnel costs are reasonable
If waiting time was reasonable
The quality of services provided
The quality of staff performance
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Review of PFA Forms
Codes and Labels
Staff Worksheet
Clinic Register
Staff Register
Staff Non-contact and Unavailable time
Client Register
Client Non-contact and Unavailabletime
Client Sign-in Sheet
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Modified Client Register
Patient Flow Analysis Client Register
for Windows
Data Set Name ________ ________________ ________________ ___________
Client ID#
Reason For Visit
Subclassification
Time of Appointment
__ __ : __ __ __ M
Time of Arrival
__ __ : __ __ __ M
# Staff ID Task Start End
1 __ __ : __ __ __ M
__ __ : __ __ __ M
2 __ __ : __ __ __ M
__ __ : __ __ __ M
3 __ __ : __ __ __ M
__ __ : __ __ __ M
4__ __ : __ __ __ M __ __ : __ __ __ M
5 __ __ : __ __ __ M
__ __ : __ __ __ M
6 __ __ : __ __ __ M
__ __ : __ __ __ M
7 __ __ : __ __ __ M
__ __ : __ __ __ M
8 __ __ : __ __ __ M
__ __ : __ __ __ M
Reason Unavailable Start End
__ __ : __ __ __ M
__ __ : __ __ __ M
__ __ : __ __ __ M
__ __ : __ __ __ M
Non-Contact Task Start End
__ __ : __ __ __ M
__ __ : __ __ __ M
__ __ : __ __ __ M
__ __ : __ __ __ M
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Computer Skills
Accessing WinPFA Data entry
Editing/correcting errors
Printing reports Printing graphs
http://images.google.com/imgres?imgurl=http://www.twu.edu/is/images/Presby%2520Computer%2520Lab.jpg&imgrefurl=http://www.twu.edu/is/PresbyterianCampus_classroomlabs_descriptions.htm&h=300&w=400&sz=33&hl=en&start=1&tbnid=jiKeMEVytrfg1M:&tbnh=93&tbnw=124&prev=/images%3Fq%3Dcomputer%2Blab%26svnum%3D10%26hl%3Den%26lr%3D8/3/2019 Elam-Miller Day 2 Breakout 1130 Am-R
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Planning the Study
Each pair was expected to completea PFA study, including:
Developing forms Orienting Staff
Completing a study
Enter data and print reports andgraphs
Bring copies of materials to Part 2
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Important Reminders
Study coordinators will set the tonefor staff attitudes about PFA
PFA is not a monitoring tool Keep it simple!
There are resources available for
any questions
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Training of Providers:Part 2
Part 2 took place 4-5 weeks after
the first training
Participants brought with them
copies of their reports and graphs
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Part 2
How to interpretthe reports (12)
and graph
Developing anAction Plan
Working with staff Practice sessions
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WinPFA Summary ReportDate
_____________________________________________________________________________The data shown below in this report provides an overview of theclinic session documented by your PFA study. These data, as wellas the data found in the body of the report, are dependent on yourstudy design and your ability to carry out that design; for studydesign considerations and data collection procedures, please seethe Patient Flow Analysis for Windows(WinPFA) Data Collection Manual; torequest a draft copy send an e-mail to [email protected].
Introduction
Number of Appointments made; 20Number of Appointments kept; 13 65.00%Number of Staff; 9Clients Served InSession; 15Clients Served Not InSession 0
Number of Contacts; 88Number of NonContacts; 0Number of UnAvailables; 4
Number of Events; 92Published Clinic Hours 1:00:00 PM to 5:00:00 PMEarliest Time in the Data Set 12:30:00 PMLatest Time in the Data Set 5:00:00 PM
Earliest Time, Client 12:30:00 PMLatest Time, Client 4:51:00 PMEarliest Time Available-To-Serve 12:30:00 PM
Latest Time, No-Longer-Available-To-Serve 5:00:00 PM
Client-Oriented Data% of
Client Activity Duration Total Time(Minutes)
in ClinicContact Time 36.10 48.70%Non-Contact Time 0.00 0.00%UnAvailable Time 0.00 0.00%
Gross Waiting Time 38.03 51.30%Total Time in Clinic 74.13 100%
Staff-Oriented Data; Average Work Day
DurationPer Staff % of Total % of
Service Type Minutes Minutes Staff DeliveringContact 83.83 100.00% 100.00%Non-Contact 0.00 0.00% 0.00%Total 83.83 100.00%
Staff-Oriented Data; Service Delivery Duration
Total | Duration (min) | % of TotalActivity Duration | For The Average | Workday
(Minutes) | Staff | Client |
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The Graph
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Developing an Action Plan
Post selected results for staff to review within severaldays of study
Schedule staff meeting (not more than 1 hours in
length) within a week of study Explore what is working well and identify challenges
Brainstorm ideas to resolve challenges identified
Develop solutions that could work
Using reaching consensus technique select 1 3
solutions to implement Assign tasks
Develop time line (including when the follow-up studywill be performed)
Repeat PFA as designed in time line
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Observations from site visits
Staff Cooperation
Changes in Scheduling Practices
Changes in Clinic Flow
Confirmation and Statistical Data
Anecdotal stories
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Where Do We Go FromHere
Share Best Practices
Evaluation of the Project Provide a Review
a. Computer Techniques
b. Data Analysis
c. PFA Graph
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Contact Information
Anne Elam
(804) 864-7754,[email protected]
Shelley Miller(215) 985-2645
CDC: Bill Boyd770 488-6301
www.cdc.gov/reporductivehealth/Products&Pubs/PFA_support/index.htm
mailto:[email protected]:[email protected]://www.cdc.gov/reporductivehealth/Products&Pubs/PFA_support/index.htmhttp://www.cdc.gov/reporductivehealth/Products&Pubs/PFA_support/index.htmhttp://www.cdc.gov/reporductivehealth/Products&Pubs/PFA_support/index.htmhttp://www.cdc.gov/reporductivehealth/Products&Pubs/PFA_support/index.htmmailto:[email protected]:[email protected]