Internship ExperienceSummary

Requested from: St. Joseph’s Hospital Family Residency Program – MHSM InternshipPresented by: Mariana Sabeva

Agenda

1. Why my Internship Project is Important to St.

Joseph

2. Expected Benefits

3. Project Objectives

4. Design a Survey

5. Survey Administration

6. Survey Results (preliminary)

7. Next Steps

8. Q & A

Internship Project Importance

1. Peppertree Family Medicine’s ultimate goal – NCQA

certified

2. My internship project – part of a multiphase project

3. Current problem – inability of patients to be seen in a

timely manner

4. Project goal – identify what causes the problem and

make suggestions for improvement

Phase I

Phase II

Phase III

Phase IV

Phase V

Phase VI

Phase VII

Expected Benefits

1. Increase of unduplicated patients2. Increase of visits3. Increase of new patients4. Show-rate increase5. Decrease of wait time for routine visits6. Patient satisfaction7. Staff satisfaction8. Provider continuity rate9. Decrease of backlogs

Internship Project Objectives

Phase I: Identify

problem Meet with

Site supervisor

Create a project plan

DEFINE

Phase II: Review

current scheduling process

Design a survey

Conduct a survey

ANALYZE

Phase III: Summarize

research on best practices

Summarize survey results

Prepare survey sample report

SUMMARIZE

Phase IV: Analyze

results Prepare

recommendation based on previous phase summaries

Present findings and recommendation to Family Medicine Program faculty board

RECOMMEND

How to Reach the Goal

1. Create a project plan with my Site Supervisor.

2. Summarize research on best practices in patient

scheduling in family medicine offices.

On a national level – literature research

On a local level – other Residency programs in Phoenix

3. Design and conduct an assessment (survey).

4. Recommend best scheduling process based on:

Best practices on national and local levels

Assessment (survey) results

Design a Survey

1. Survey goal – phone scheduling system satisfaction

2. Resources used to build the survey questions and format: Health Resources and Services Administration (HRSA), US

Department of Health and Human Services HCAHPS (Hospital Consumer Assessment of Healthcare

Providers and Systems), Medicare - Hospital Quality Initiative

3. When a survey is an assessment and you don’t need IRB (Internal Review Board) approval? Hospital has a contractual agreement with a survey vendor

(St. Joseph has an agreement with Avatar) Survey is not part of “research”, nor is the whole quality

improvement project

Design a Survey Cont’d1. Sample size estimation* – needed elements:

Target population patients per month Anticipated response rate (to adjust the sample) Confidence interval – 95% Standard deviation and margin of error (ME) – estimated*

2. Attributes: Five-point Likert rating scale ranging from “Strongly

Disagree” to “Strongly Agree” Uniform rating scale used across all questions Inclusion of two open ended questions Anonymous and voluntary Time duration – between three and five minutes Each question refers to one issue

* - Bartlett II, J., Kotrik, J., Higgins, C., Organizational Research: DeterminingAppropriate Sample Size in Survey Research, Information Technology, Learning, and Performance Journal, Vol. 19, No. 1, Spring 2001

Design a Survey Cont’d

1. Our Phone System: • Was it easy to reach live operator on the phone• Did you wait a long time to reach live operator• Were the phone menu instructions easy to understand?• Was it clear when to choose scheduler or triage nurse

2. Telephone Personnel• Was the live operator friendly and helpful• Did the live operator treat you with courtesy and in

professional manner• Did the live operator show concern and sensitivity to your

needs• Did the live operator answer all of your questions

Survey Administration1. Distribution Method:

Hand out printed assessment in the waiting room after visit Have available Spanish translated assessments if language

preference is Spanish Hand out assessment to every other patient to introduce

variability Keep track of non-respondents

2. Schedule:

Assessment Results*

* Footnote: Preliminary results are based on 63% of administered assessments.

3% 4% 6%

33%

16%

1%

SD D NAND A SA NR

Was it easy to reach live operator on the phone

9%

21%

11% 12% 9%0%

SD D NAND A SA NR

Did you wait a long time to reach live operator

3% 4% 6%

33%

16%

1%

SD D NAND A SA NR

Were the phone menu instructions easy to understand

1% 5% 8%

34%

15%

0%

SD D NAND A SA NR

Was it clear when to choose scheduler or triage nurse

1% 0% 3%

31% 28%

1%

SD D NAND A SA NR

Was the live operator friendly and helpful

Acronym SD D NAND A SA NRDescription Strongly Agree Disagree Neither Agree Nor Disagree Agree Strongly Agree Not Reported

Likert Scale (Commonly Used Psychometric Scale in Questionnaires)

0% 1% 1%

31% 30%

0%

SD D NAND A SA NR

Did the live operator treat you with courtesy and in professional manner

0% 3% 6%

30% 24%

0%

SD D NAND A SA NR

Did the live operator show concern and sensitivity to your needs

0% 3% 4%

34%23%

0%

SD D NAND A SA NR

Did the live operator answer all of your questions

Section 1 – Our Phone System

Section 2 – Telephone Personnel

Assessment Results * Cont’d

Acronym SD D NAND A SA NRDescription Strongly Agree Disagree Neither Agree Nor Disagree Agree Strongly Agree Not Reported

Likert Scale (Commonly Used Psychometric Scale in Questionnaires)

* Footnote: Preliminary results are based on 63% of administered assessments.

2% 6% 6%

29%21%

0%

SD D NAND A SA NR

Was it easy to get an appointment

3%8% 9%

25%19%

1%

SD D NAND A SA NR

An appointment was available when needed

3%8% 9%

25%19%

1%

SD D NAND A SA NR

An appointment with desired doctor was available when needed

1% 4%14%

28%18%

0%

SD D NAND A SA NR

Did the live operator verify that your insurance is accepted from our office

1% 4%9%

34%

14%

1%

SD D NAND A SA NR

Did the live operator get your address information

0% 0%7%

32%23%

1%

SD D NAND A SA NR

Did you feel that your privacy was protected

Section 3 – Ease of Getting an Appointment

Section 4 – Required Information

Patient Age/Sex Histogram*

15 10 5 0 5 10 15 20

19-29

30-39

40-49

50-59

60-69

70-79

Patient Population Age/Sex Histogram

Male Female

Age Male Female Total19-29 1 11 1230-39 5 7 1240-49 8 13 2150-59 10 12 2260-69 1 17 1870-79 0 3 3unknown 1 0 1All 26 63 89

* Footnote: Preliminary results are based on 63% of administered assessments.

Sex, Language, New Patient

* Footnote: Preliminary results are based on 63% of administered assessments.

Male, 18.6%

Female , 45.0%

Unknown, 0.0%

Sex Distribution

English, 61%

Spanish, 3% Unknown,

0%

Language Distribution

English Spanish Unknown

New, 11%

Established, 53%

Unknown, 0%

Patient Distribution

Male Female Unknown18.6% 45.0% 0.0%

English Spanish Unknown61% 3% 0%

New Established Unknown11% 53% 0%

Next Steps

1. Finish the assessment administration

2. Summarize assessment results in a report

3. Make a recommendation based on:

Best practices on national and local level

Assessment (survey) results

4. Summarize my internship experience in a report

Q & A