Primary Care Clinic Visit Efficiency

Primary Care Clinic Visit Efficiency

Kambiz Farahmand (NDSU, Fargo, ND, USA), Satpal Singh Wadhwa (NDSU, Fargo, ND, USA), Mahmoud Mostafa (NDSU, Fargo, ND, USA), Vahid H. Khiabani (MTSU, Murfreesboro, TN, USA) and Sudhi Upadhyaya (NDSU, Fargo, ND, USA)
Copyright: © 2015 |Pages: 14
DOI: 10.4018/IJUDH.2015010102


A study was done in 2013 regarding Veteran's Affairs primary care clinics in New Mexico. The primary care clinics provide care for a group of patients on regular basis. They also see additional patients as needed. The team consisting of the provider(s), nurse(s), technician(s), and schedulers providing continuous and coordinated care throughout patient's life-time is called Patient Aligned Care Team (PACT). The purpose of the PACT is to maximize patient care using this continuous and familiar care model for the patients. The performance of five out of ten primary care teams were provided using the traditional measures identified by their healthcare system in the Patient Aligned Care Teams Compass Data Definitions. The measurements that were specifically interesting were Ratio of PC Telephone Encounters to All PC Encounters, Ratio of Non-Traditional Encounters, Same Day Appts. w/PC Provider Ratio, Continuity PCP (ER Excluded), Team 2ndDay Post DC Contact Ratio. The data was collected in 2012 and the evaluations, interviews, and analysis was completed in 2013. The team scores was provided and access was obtained to only five out of ten teams which data was available for. The Veteran's Affairs provided data regarding the performance metrics of the PACT teams. The data was evaluated by using statistical correlations. The interview questions were designed to further dissect the performance of each team and their practices. Teams were interviewed and the responses were summarized and analyzed. Responses from each team were converted into team's scores and compared to their PACT performance metrics. The comparison between teams' scores and PACT performance metrics provided insight into each team's perception of its own performance and its PACT performance metrics. The purpose of this project is to identify the value adding and non-value adding activities of the each team. So the management can encourage the promotion of value adding activities, decreasing the variation in the performance of the teams and so maximizing the patient care.
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Data Collection

One of the prerequisites of the current healthcare practice is the clinic visit. However, the emergence of tele-health and Web technologies raises the possibility of substitution of virtual (synchronous and asynchronous) interactions with patients as alternatives to face-to-face encounters in clinics. This study examines the current utilization of such technology and other approaches used by several primary care clinics with a focus on improving access and quality of care given to the patients.

The clinic performance data which included Performance Measures identified by the healthcare organization was provided for ten primary care clinics along with the scores associated with the Performance Outcomes shown in Table 1. The scores in the green are considered good and the scores highlighted in red are poor scores for the team performance for that measure in that category.

Table 1.
Score of different measures for 10 primary care clinics

The correlation analysis was performed between the performance measures and the identified outcomes to examine relevancy and accuracy of the measures used. A survey tool was then developed to verify the correlation relationships between the measures and outcomes. Five out of ten primary care clinics chose to participate in the survey. A copy of the survey tool is shown below.

The following is the survey tool and the list of the questions in the order they were asked from the providers who participated in the survey.

Value Analysis of Clinic Visit Project - Survey Questionnaire

  • Date & Time: _______________

  • Interviewer Name: ____________________

  • Pact Team#: _____

  • Interviewee Name: __________________________

  • Role of the Interviewee (Nurse/Provider/Other…):__________________________

  • Interviewee Primary Office Location: _________________________

  • Interviewee FTE/Non-FTE: _______________________

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