Chico Eye Center Sees Measurable Improvements with Visual Clinic

Voted “Best of Chico” since 2009, Chico Eye Center is located about two hours north of Sacramento and has been serving local residents and the surrounding community for more than 40 years. In addition to routine eye care, Chico prides itself on providing a range of specialties and subspecialties to serve patients who would otherwise have to travel the considerable distance to UC Davis in Sacramento for specialty treatment. 

The interests of its patients are the Center’s highest priority, and a core tenet of Chico’s mission is to consistently exceed service and care expectations. “A large measure of our success is to continually give efficient care to our patients,” said Jana Gilbert, Practice Administrator for Chico Eye Center. “Being more efficient in our practice allows us to spend more direct quality care time with our patients.” 

When it became apparent that inefficiencies were creeping into the system, as evidenced by longer than desired wait times, it was important to find out what was causing bottlenecks in the patient journey.  An outdated “light” system used for patient flow and manual time stamping through their EHR proved inconsistent and unreliable, and the Center knew it had to find a better way. 

The perfect opportunity presented itself when the old system failed and the cost of repairs proved prohibitive. Having heard of Visual Clinic through word of mouth, Chico began investigating and soon learned that the software, which uses process data, analytics and modern workflow visualization, would be just the solution they needed to improve the patient experience.  

A Customizable Solution That Scales With Clinic Growth 

Chico implemented Visual Clinic’s Lean Flow Manager four years ago, in 2019, and has never looked back. Visual Clinic is a custom visual management software company offering a number of solutions to help eye care clinics work more efficiently and profitably. Their best-in-class patient flow management software solution, Lean Flow Manager, is built on the principles of Lean Six Sigma and provides clinics with real-time visibility into practice workflow and resource allocation to optimize capacity while providing a dramatically better patient experience.

With around 40 users in all areas of the clinic, including the front desk staff, ophthalmic technicians, doctors and opticians, Visual Clinic not only solved the initial challenge of optimizing the workflow to improve the patient experience, but also provided additional solutions including more effective management, more informed scheduling, and increased optical sales. 

“Visual Clinic’s Lean Flow Manager allows us to use our existing resources more efficiently, which lowers our operating costs,” said Dr. Pablo Arregui, a founding member of both Chico Surgery Center and Advanced Eye Surgery Center. “In addition, we’ve been able to streamline our patient flow, allowing us to see more patients in the same amount of time. Both of these outcomes have led to a measurable improvement in Chico Eye Center’s bottom line.”

Better Communication Means an Improved Patient Experience

Although Chico began using Lean Flow Manager in 2019, the clinic moved into a brand new facility in 2022, requiring new customizations and features. Visual Clinic worked closely with Ms. Gilbert and her team to update the software to match the new workflow and customize it for each of the clinic’s six doctors, thereby helping Chico streamline the patient journey for greater efficiency.

The new building comprises a large reception area, an open optical retail area in the center of the space, and a series of clinical pods where direct care takes place. Patients are checked in, entered into the workflow, and immediately appear on the Lean Flow Manager screen which shows the status and location of all technicians, doctors, and patients in real time. The patient is sent through to the appropriate pod and upon arrival, an ophthalmic technician is ready and waiting for them, having seen on the screen that he or she was on the way. Since the reception and pod areas are physically separated, it was important for Chico to make patients feel comfortable walking back on their own and added a customized “notes” section to the software where a brief description of the patient is entered. This allows the technician to recognize the patient and greet them by name. Patients value this personalized approach and have voiced their appreciation that Chico uses the latest technology to improve their experience. 

With Lean Flow Manager at their fingertips, technicians also feel more engaged in the overall patient experience and more empowered to make last-minute decisions in the best interest of efficient flow. For example, even though patient A checked in before patient B, they know – because they have the big picture in front of them – that patient B’s workup will be quicker and can prioritize patients in a way that keeps the flow going to avoid delays. 

The same is true for the optimal use of space. Chico’s technicians can see at a glance which rooms are available. If all the workup rooms are taken but an exam room is available, testing can be done there instead of having the patient wait. Likewise, if there are no rooms available in Pod B, but there’s availability in Pod C, patients can be taken there for testing to maximize efficiency. Prior to Visual Clinic, technicians had no insight into these possibilities. 

“Being able to see where patients are at all points in the workflow has made our whole team more proactive,” said Dr. Sean Liston, a cornea specialist at Chico. “Together, we’ve been able to identify and solve bottlenecks in our processes, thereby lowering wait times and improving the patient experience for each patient that comes through the door.”

Visual Clinic has helped map and track each step in Chico’s workflow, including the role of the scribe. Since each step in the process is color-coded and easily identified with a quick glance at the Lean Flow Manager screen, Ms. Gilbert quickly sees when the scribe might be out of sync with the doctor and steps in to keep everyone on track. “It’s all about efficiency,” says Ms. Gilbert. “We want patients to have a nice smooth visit when they’re here so they can get on with their day. Lean Flow Manager keeps the entire patient journey on track.”

Of course, it’s not just about time. Everyone at Chico is committed to making sure they’re providing the best possible patient care. To that end, each doctor also has Lean Flow Manager displayed in their office so they see instantly whether or not another patient is waiting for them. If not, the doctor is happy to take a few extra minutes with the patient to provide that extra level of care. “Most importantly, the consistent flow of patients means I’m able to provide better care to my patients,” said Dr. Liston.

Greater Efficiency Through Visual Management

In addition to optimizing the patient experience, Ms. Gilbert finds Lean Flow Manager to be an effective management tool. The efficiency of the overall workflow depends on the efficiency of everyone involved so it is important to understand where bottlenecks are occurring. With the help of Visual Clinic, Ms. Gilbert knows the average length of time tasks should take and she is alerted to any delays that need to be addressed. Lean Flow Manager software provides real time, accurate data that displays a wealth of information with a glance at a screen. “It has been a huge time saver on the managerial side of patient flow,” she says. “Wherever the patient is virtually, the patient is physically.”

Customized reports show objectively whether goals are being met and where there are shortfalls. When technicians are engrossed in their work, it’s easy to lose track of time, however, the visual displays encourage everyone to be mindful of keeping the flow going. Using the data, Ms. Gilbert is also able to identify potential staffing shortages or other personnel issues that might need to be addressed. Monthly perqs for reaching specific milestones has led to friendly competition amongst staff which serves to boost morale. 

“Best of all, if a day does go off the tracks, I can go back and figure out what happened,” says Ms. Gilbert. “I can also spot if there is a trend for what’s going on at a specific time of day or day of the week? If so, I can most likely address the issue through scheduling.” 

Evidence-based Scheduling At a Glance

Effective scheduling, of both patients and staff, is a key component of an efficient workflow without delays or unnecessary wait time. According to the principles of Lean Six Sigma, we know that clinic schedules should be created based on the average individual exam time for each doctor. With the help of accurate data from Visual Clinic, Ms. Gilbert can create schedules that keep the entire workflow leading up to the exam appropriately time-balanced for each doctor in the clinic. This allows Chico to keep the workflow moving at a steady pace: not too fast, not too slow. 

“As the practice administrator, one of my more challenging tasks is creating the weekly schedules,” said Ms. Gilbert. “Visual Clinic’s software makes this so much more efficient by providing me with the accurate data needed to make informed decisions about whether we’re staffing correctly for the number of patients we have coming in the door.”

A Forward-Looking Practice That’s Seeing Measurable Results

When patients visit Chico Eye Center and see the large screens in use across the clinic, they are always impressed with Chico’s visible commitment to quality service. 

As another sign of their desire to create a positive overall patient experience, Chico recently added the Total Rx Capture module from Visual Clinic and is seeing good results. This module was designed to increase the capture rate of optical retail sales opportunities and Chico has seen a 25% improvement in just the first few months. “With the new office configuration, there is a large retail space in the middle of the clinic that people have to walk through to get in and out of the pods,” said Ms. Gilbert. “Our optical department is very busy, with patients coming from six doctors at potentially the same time, and add in walk-ins, it can be quite overwhelming. Total Rx Capture allows us to capture every opportunity so that we can seamlessly complete the circle of care.”

Chico’s use of the latest technology to improve the employee experience as well has played a large part in attracting the highest quality doctors and staff. Ms. Gilbert aims to work with people who understand the importance of Lean Flow Manager and buy into it as much as they do since it is ultimately those people who will be the best fit with the practice, making for a better work environment. 

Since moving into its new building, Chico Eye Center has decreased cycle time by nearly 10% across appointment types, thanks to Lean Flow Manager. “While it goes without saying that the quality of care comes first, if we can decrease wait times and appointment times while maintaining that quality then we’ve done our job,” says Ms. Gilbert. “I honestly think Visual Clinic is fantastic, and I don’t know why people would use anything other than a system like this.”