Elam-Miller Day 2 Breakout 1130 Am-R

8/3/2019 Elam-Miller Day 2 Breakout 1130 Am-R

1/22

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


2/22

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


3/22

Issues we hoped to Explore:

Clinic Waiting Time

Utilization of Staff Flow of Services

Secondary By-product: Greater Staff Satisfaction

Decrease Patient Frustration


4/22


5/22

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


6/22

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%3D


7/22

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


8/22

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


9/22

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


10/22

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


11/22

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


12/22

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%3D


13/22

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


14/22

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


15/22

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


16/22

Part 2

How to interpretthe reports (12)

and graph

Developing anAction Plan

Working with staff Practice sessions


17/22

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 |


18/22

The Graph


19/22

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


20/22

Observations from site visits

Staff Cooperation

Changes in Scheduling Practices

Changes in Clinic Flow

Confirmation and Statistical Data

Anecdotal stories


21/22

Where Do We Go FromHere

Share Best Practices

Evaluation of the Project Provide a Review

a. Computer Techniques

b. Data Analysis

c. PFA Graph


22/22

Contact Information

Anne Elam

(804) 864-7754,[email protected]

Shelley Miller(215) 985-2645

[email protected]

CDC: Bill Boyd770 488-6301

[email protected]

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]

Documents

Elam-Miller Day 2 Breakout 1130 Am-R