Illinois Eye Center Views Data Through A New Lens For A Better Patient Experience
Illinois Eye Center comprises three eye care clinics located in Peoria, Washington, and Pekin, Illinois, and provides patient-centered access to the most comprehensive multi-specialty team, integrated diagnostics, and advanced therapeutic technologies in the region. Fourteen ophthalmologists and nine optometrists offer a variety of specialties including glaucoma, retinal disease, refractive, neuro-ophthalmology, oculoplastics, and corneal disease, in addition to routine eye care. The practice also offers same-day urgent care services and routine vision exams in its Peoria location, through a service called EyeCare Today.
With approximately 115,000 patients seen annually across locations and specialties, Illinois Eye Center is a large, busy, and complex practice requiring a sophisticated approach to planning, resource allocation, and scheduling to ensure the best possible patient experience. “We consider ourselves a progressive practice and are always looking to optimize and modernize,” says Tim McCormack, Executive Director of Illinois Eye Center. “Part of that modernization effort is finding new ways to continually improve the patient experience.”
When practice managers began fielding concerns from patients about visit wait times, the Center saw an opportunity for improvement. Long wait times signal inefficiencies in the workflow and mean that the interdependent steps in the process are not working together effectively to optimize direct care. Because reduced wait time for patients invariably leads to increased uptime for doctors, Illinois Eye Center knew it had to identify where these inefficiencies were occurring and rectify them.
Using the Center’s existing EHR system to analyze patient flow and spot bottlenecks proved complicated and yielded less than satisfactory results. In an attempt to develop a better system, Illinois Eye Center’s IT team built an in-house program to track the patient journey; however, since it still required manual inputs, it did not provide a completely accurate picture of what was happening across the practice. Too much room for human error ultimately undermined the integrity of the resulting data.
Abby Jackson, RN, DNP, Director of Patient Services at Illinois Eye Center, began a thorough analysis of available practice management tools to determine if there was a product that would meet their needs. Having been introduced to Dennis McCafferty, President of Visual Clinic®, more than two years prior, she circled back with him to discuss how Lean Flow Manager™ could benefit their practice. Visual Clinic is a custom visual management software company offering a number of solutions to help eye care clinics work more efficiently and profitably. The cloud-based, 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. It was the solution they were looking for.
A Clear Vision For A Customized Solution
After observing several real-world use cases in the area, Ms. Jackson was convinced of its efficacy and Illinois Eye Center implemented Lean Flow Manager in all three of its locations. Because so much work had already been put into the in-house system, Visual Clinic worked closely with the Center’s internal team to integrate as much as possible into a custom-designed solution. Now, the built-in triggers of Lean Flow Manager mean that the resulting data is no longer subject to human error and the real-time graphic displays provide a powerful visual management and reporting tool.
Dennis McCafferty and his team further adapted the software to accommodate additional requirements unique to Illinois Eye. For example, it is not uncommon for doctors to move offices—sometimes even locations—throughout the day, making automatic tracking a challenge. The Center feared this might require manual inputs, but since this movement was already being captured electronically elsewhere, Visual Clinic was able to build an integration into the software. Now, all systems talk to each other and if someone moves during the day, Lean Flow Manager automatically picks that up and moves with them.
Also unique is the Center’s urgent care clinic which adds patients at random throughout the day, further complicating the challenge of optimized resource allocation. Visual Clinic tailored the software to include customized minute-by-minute updates to give a more accurate picture of where patients, staff, and doctors are at all times. With the help of this data, Illinois Eye can create schedules that keep the entire workflow appropriately time-balanced for each doctor in the practice. Illinois Eye Center also asked for a number of custom views that would help their operations run more smoothly, which Visual Clinic was happy to provide.
“They are one of the easiest vendors that I work with,” said Ms. Jackson. “Instead of telling us what their software can do, they listen to us and customize it to our needs. They’re always available to jump in to help and I really appreciate that collaboration.”
“A large part of our success comes from the positive relationship with the Visual Clinic team,” added Tim McCormack. “We articulate what we need, and they take our vision and deliver just what we want.”
Today, all clinic, surgery, scheduling, and Lasik staff, technicians, and scribes use Lean Flow Manager on a daily basis. Optical staff, too, use Visual Clinic’s Total Rx Capture module to manage patient flow through the dispensary to effectively increase their capture rate of optical retail sales opportunities.
Visual Management: Like Having Eyes in the Back of Your Head
Prior to implementing Lean Flow Manager, Illinois Eye Center relied on a flow supervisor to personally observe patient flow and identify bottlenecks. The physical accumulation of patient charts, however, did not give a true indication of how long individuals had been waiting and didn’t provide insight into what was causing delays and why. Were rooms not clean? Was staff not available? Were doctors not ready?
Now, with color-coded graphic displays visible throughout the practice, all staff members can see at a glance how many minutes each patient has been waiting, which resources are available to meet patient needs, and when the doctor is ready to receive the next patient. This real-time visibility into the patient journey ensures each patient moves through the workflow as smoothly as possible and allows the care team to better react to bottlenecks to keep all patients progressing at a pace in step with the doctor.
“One of the main benefits of Lean Flow Manager is the ability to track the visit every step of the way,” said Abby Jackson. “I call it our ‘air traffic control system’ because it’s so powerful. It’s one screen where I can see all doctors, patients, and staff for all three of our offices at once. Even though I may be physically in Peoria, I can see at a glance if our Washington clinic needs help and can proactively communicate with staff to help.”
Several staff members at Illinois Eye Center can perform dual roles but didn’t always know when it was appropriate to switch. This uncertainty often meant precious minutes were wasted. With the help of Lean Flow Manager, staff know where they are needed most, allowing them to take initiative rather than wait for instructions from someone else.
“Given the size and complexity of the 45,000 sq ft Peoria office, we were looking for a tool that would help manage the patient flow as it was occurring in real time,” said Tim McCormack, Executive Director of Illinois Eye Center. “Using the visual displays of Lean Flow Manager throughout all three of our clinics means we can monitor things as they happen without having to leave our desk. This visual management capability is very important to us.”
With this knowledge, staff are able to better manage patient expectations around wait times, too. Instead of guessing, patients are given realistic timeframes, which they seem to appreciate: Since the implementation of Visual Clinic, Illinois Eye Center has recorded fewer patient concerns about wait times.
Collecting Data for Eye-Opening Reporting
Measurably improving the patient experience meant collecting robust and accurate data around total visit time as well as the time required for each step in the workflow to determine where and why delays were occurring. Rather than relying on personal opinions or assumptions about what may have happened during a given day, Illinois Eye Center is now able to point to the data to make informed decisions about better streamlining the patient journey.
“Our doctors are data people and appreciate when we can quickly show them the numbers,” said Tim McCormack. “They all recognize the value of this type of analysis. We want to use the data to make positive changes in our practice to improve the patient experience.”
By automatically and consistently collecting and measuring patient milestone metrics through Lean Flow Manager, from check-in to check-out, practice managers can see, objectively, the average length of time required to complete each step in the workflow. While times vary by doctor and specialty, managers can use this information to schedule staff and patients in such a way to avoid bottlenecks and delays to optimize the workflow for each doctor.
The value in any eye care practice—for both patients and the clinic’s bottom line—lies in the time patients spend in direct care with doctors. It is important therefore, to maximize direct care and allow each doctor to see as many patients as he or she has the capacity to see but, when inefficiencies in the form of bottlenecks and roadblocks make their way into the workflow, doctors are unable to achieve maximum capacity.
The Center’s management team reviews two reports generated daily by Visual Clinic to understand what’s happening across the practice to spot trends and potential anomalies. The first report shows each doctor’s time spent in direct care versus time spent waiting for a patient. The second tracks patients’ length-of-stay: time spent from check-in to tech, tech to doctor, doctor to check out, and total visit time. The data provided by Lean Flow Manager allows Illinois Eye Center to spot and unclog bottlenecks to optimize resource allocation and patient volume to move the entire practice closer to maximum capacity.
Illinois Eye Center now has full insight into how—and how efficiently—each of their doctors, technicians, scribes, and staff interact with each other and with patients. Armed with this information, the Center has been able to improve patient journey efficiency across all three clinics by an impressive 29%. While individual “door-to-doctor” metrics vary, several doctors have improved overall patient service times by more than 40%.
Shining a Light on Productivity
Using data to understand how long each step in the patient journey should take and analyzing the daily reports allows practice managers to more accurately and objectively assess staff productivity. There are, of course, many reasons a patient visit can run long and rather than using it for punitive purposes, the data gives Illinois Eye Center the opportunity to address potential problems through skills training or other support if necessary. While some were initially skeptical, the staff understands that this type of reporting is in the best interest of the patient and the practice, as well as their own professional development.
In the spirit of continuous improvement, Illinois Eye Center is currently identifying a subset of performance metrics that it plans to share regularly with doctors and staff alike. By sharing these metrics, together with the team’s progress towards specific practice-wide goals, Illinois Eye Center hopes to build an even stronger team culture. It can be all too easy to lose sight of the big picture during the stress of the day, but when everyone is working together towards a common goal, productivity is expected to increase. “We love our practice but we can always do better,” said Tim McCormack. “Everyone in the practice is responsible for creating a better patient experience. And when individuals can see the impact of their actions on the metrics we choose to highlight, they just might be a bit more inclined to go above and beyond to get us across the finish line.”
Looking Ahead to Next Steps
Illinois Eye Center aims to institutionalize a culture of continuous improvement by taking an even more sophisticated approach to data analysis and reporting. Using the Plan-Do-Check-Act approach inherent in Lean management, Illinois Eye Center regularly reviews processes, systems, and data to assess what is working well and what else can be done to improve practice efficiency and the patient experience. To that end, the practice has created a dedicated Patient Experience Analyst position that will focus primarily on making the most of the data they’re collecting.
“When implementing Lean Flow Manager, our goal was to provide a better patient experience, from both a time and efficiency standpoint,” says Tim McCormack. “It’s pretty clear we’ve been able to hit that mark. We’re excited now to take full advantage of the information and data and take the patient experience to the next level.”
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