Improving Clinical Wait Times in a Veterans Affairs' Urologic Setting

Abstract

Background: Long clinic wait times can contribute to treatment delays and decreased patient satisfaction. Veterans are often waiting in the urology clinic for a prolonged period that delays treatments including possible surgical interventions leading to patient dissatisfaction. Purpose: The purpose of this quality improvement project was to decrease the overall procedural wait times in an outpatient urology clinic by implementing a Fast-Track procedural clinic. Methods: The Fast-Track procedural clinic was developed to expedite care for veterans actively under bladder or prostate cancer surveillance, employing lean methodology principles. We also utilized the Consumer Assessment of Healthcare Providers and Systems Outpatient and Ambulatory Surgery Survey (OAS CAHPS) tool to assess patient satisfaction with the newly implemented Fast-Track clinic. Wait times were collected and analyzed by SPSS statistical software to determine the effectiveness of a Fast-Track clinic. Results: The Fast-Track clinic was implemented to veterans presenting to the urology clinic for procedural appointments from June 2021 to December 2021. The usage of a Fast-Track clinic decreased the overall wait times from 131 to 75 minutes within 8 weeks (43% improvement). The OAS CAHPS tool found that 55% of veterans received easy-to-understand instructions pre-Fast-Track implementation, compared with 59% post-Fast-Track implementation (a 4% improvement). Furthermore, 82% of veterans reported that they did not receive written discharge instructions post-Fast-Track implementation compared with 32% pre-Fast-Track implementation. Conclusion: Incorporating a Fast-Track procedural clinic helped minimize wait times, leading to a reduction in procedural wait times and urologic surgical delays. Implications for Nursing: The implications for practice include future studies focusing on other strategies for improving clinic wait times including block schedules and qualitative measures in the urologic and other specialty areas.

Keywords: clinic; cycle time; fast-track; outpatient; patient satisfaction; procedure; wait times.