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Introduction: Clinic process inefficiencies cause lengthy visit and wait times, which frustrate patients and providers and limit clinic capacity

Objective: To identify process inefficiencies and assess process flow interventions

Methods: Prospective, consecutive series of resident clinic visits over a 3-week period after transferring refraction from tech to resident. Personnel recorded the time spent waiting for and undergoing each clinic process. The clinic also piloted a “Fast Track” from registration to resident for appropriate established patients.

Results: Patients spent 53% of the visit waiting, primarily for the tech. Transferring refraction from tech to resident decreased the wait for tech and tech duration without increasing resident duration. There was no significant reduction in total visit or wait times. “Fast Track” decreased total visit time by 38% but comprised only 3.5% of visits that may have been appropriate.

Conclusion: Reallocating a task from the slowest process decreased that process’s wait and duration but had no effect on total visit or wait times. Process flow analysis identifies inefficiencies and assesses interventions. Automated data collection is crucial for iterations.

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quality improvement, process flow analysis


Medical Education | Medicine and Health Sciences | Ophthalmology


Presented at the 2019 House Staff Quality Improvement and Patient Safety Conference

Optimizing Resident Clinic Efficiency Through Process Flow Analysis