When Diane Dickie’s family physician referred her for physical therapy for an ongoing lower back problem that severely limited her ability to move, she thought back to when her husband had been referred to Lloydminster Hospital’s Outpatient Therapy program for his own knee problem. He was told the wait for the initial assessment would be about 36 weeks.
“I was prepared to go somewhere else because I couldn’t wait that long,” Dickie said, “but your benefits only cover so much private care.”
So she went to the Outpatient Clinic at the hospital, ready to be told of the long wait and to have to make a decision about where to seek treatment.
“I walked in and was shocked I got right in for an assessment,” Dickie said.
She has since had three treatments and is beginning to find relief from the lower-back pain that impacted all areas of her life, including her ability to work as a health information management practitioner with Prairie North Health Region. Her husband has also begun treatment, having a much shorter wait time than what was originally expected.
So how did the Lloydminster Hospital Therapies staff manage to decrease an average patient wait time of 425 days (as of October 16, 2014) to a maximum wait time of seven days? It started with a hard look at the current process for booking a patient’s initial assessment.
“Our team knew the wait-list situation was dire,” said physical therapist Devin Mann. “We had talked about the situation before, and had come up with some ideas for improvement, but it wasn’t until we created a value stream map of our process and saw it in black and white that we were able to commit as a team to a plan for testing improvements.”
The team looked at what other departments were doing to improve patient access and used Lean approaches to improvement: ‘try-storming’ ideas, using the plan-do-study-act cycle to see what was working, and developing standard work so that all staff and all patients were getting the same messages.
The assessment process was changed to open a walk-in clinic every Wednesday morning for any patients needing physical therapy. Once patients are assessed, they are immediately scheduled for subsequent treatment appointments. Over the course of 13 weeks, all 368 patients on the wait list were contacted to let them know of the change in process and invite them to a walk-in clinic. Since January 14, 2015, the Therapies team has eliminated its wait list, and all patients have been assessed within a week – the maximum length of time before the next walk-in clinic.
Staff members are pleased with the changes and are committed to sustaining and continuing with improvements.
“It is very beneficial to see patients in an acute stage and give them the tools to succeed immediately, versus seeing a patient a year down the road when the patient’s problem has continued to grow,” said physical therapist Keenan Oberg.
Patient Diane Dickie agrees.
“The sooner you can get in, the better – especially for people like my husband, who are waiting for surgery, so that they can start exercises and build up strength. As a patient, I’ve had a very good experience – the staff here are very caring and very knowledgeable.”