June 2015
Volume 56, Issue 7
ARVO Annual Meeting Abstract  |   June 2015
Alterations to Clinic Workflow for Patients Undergoing Intravitreal Therapy: A Time-Study Evaluation and Patient Satisfaction Survey
Author Affiliations & Notes
  • Jamie Reese
    Cole Eye Institute, Cleveland Clinic, Cleveland, OH
  • Justis P Ehlers
    Cole Eye Institute, Cleveland Clinic, Cleveland, OH
  • Footnotes
    Commercial Relationships Jamie Reese, None; Justis Ehlers, Alcon (C), Bioptigen (C), Bioptigen (P), Genentech (F), Leica (C), Synergetics (P), Thrombogenics (C), Thrombogenics (F), Zeiss (C)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 1397. doi:
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      Jamie Reese, Justis P Ehlers; Alterations to Clinic Workflow for Patients Undergoing Intravitreal Therapy: A Time-Study Evaluation and Patient Satisfaction Survey. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1397.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose: Patients receiving intravitreal therapy are often burdened with frequent and long clinic visits. In order to facilitate reduced wait-times and improved patient satisfaction, changes were implemented to clinic scheduling and overall workflow. The purpose of this study is to assess the impact of those changes on patient visit times and patient satisfaction.

Methods: This was a retrospective review of clinic workflow and a patient satisfaction survey. IRB exemption was granted from the Cleveland Clinic. Previous clinic workflow standard (Phase A) was as follows: check-in, technician work-up, imaging, physician exam, preparation and injection of intravitreal therapy, if needed. Each step required a room change and a wait period.<br /> <br /> To streamline the process, we created a “fast-track” workflow (Phase B). We analyzed the “unnecessary” steps and excess in the process. A new visit type was created to identify those patients who were undergoing intravitreal therapy (e.g. PRN, treat-and-extend, regular interval). A special folder is utilized to identify those patients throughout the visit. After imaging, the patient is placed directly into a designated fast-track room, where the patient remains for the duration of the visit.<br /> <br /> To assess the effectiveness of these changes, we identified 25 patients who had 2 visits in both Phase A and Phase B. Time points for various milestones of the visits were collected from the medical record (e.g., check-in, dilation, check-out) and compared between the 2 phases. A patient survey was also administered regarding their experience in both Phase A and Phase B, such as perceived number of stops and wait times (1 being best, 4 being worst).

Results: Mean time from work-up to check-out time was 86 min in Phase A. This was reduced to a mean time of 71 min in Phase B, a 17% reduction (p = .003). The mean patient satisfaction score for wait time during Phase A was 2.6/4, following the change the mean score during Phase B was 1.4/4.<br />

Conclusions: Our results suggest that simple changes to clinic workflow and overall assessment of “wasted” time can improve visit times and patient experience in the vitreoretinal clinic for patients undergoing intravitreal therapy.<br />


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