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    Elise Dieringer
    Elise Dieringer, BSN, RN

    When Aurora Health designed and built our “clinic of the future” years ago, there were two identified components to help us optimize clinic capacity and patient experiences. What we’ve learned helped our health system standardize a workflow model supported by technology that is now used in more than 20 clinics throughout the health system, including two that I manage.

    1. Self-rooming. Almost unheard of at the time and still gaining popularity today, self-rooming allows patients to bypass the waiting room and offers the perception that an appointment starts immediately upon the patient’s arrival. In our self-rooming model, patients are given a real-time locating system (RTLS) badge and use wayfinding techniques (similar to a hotel) to navigate to their dedicated exam room. Here they receive all services in a collaborative care model: labs, ultrasounds, consults, social work. Unless X-ray imaging is needed, they never have to leave the exam room, making their experience patient-centric and non-disruptive.  
    2. Measuring operational outcomes. However, you can’t measure what you can’t see — or what you aren’t tracking, for that matter. To maximize clinic efficiency and provider capacity, we needed data to support process improvements. That’s where RTLS technology came in. With RTLS as the backbone in our clinical workflow, we have access to real-time information such as patient location, room status, patient wait time, overall length of stay, who has or hasn’t seen the patient yet, how long a provider has been with a patient, just to name a few. This real-time data helps keep patient visits moving in the moment, and it’s also recorded for analysis, giving us accurate insights to help us identify bottlenecks, trends and hidden revenue.

    Following are several ways we’ve leveraged RTLS data to maximize our providers’ time and improve patient satisfaction.

    Optimized room utilization

    I often have providers coming to me requesting exam space in my clinic. They may already be practicing here and want more space; or they may be a specialist who would like to see patients at this location. This isn’t always an easy request to fill, but it’s important that we invest time to see what is possible. For providers who practice here already, the RTLS data tells us how often and how long the provider is in the exam rooms they already have. Sometimes they may not be using their existing space effectively, and we can then adjust in scheduling or other process improvements before assigning them more space. In the case of adding specialists, the RTLS data lets us see which exam rooms have additional capacity. Our providers are very receptive to the data, because let’s face it, in healthcare, we thrive from having evidence to make decisions.

    More informed scheduling

    We want to help our providers see as many patients as they can without reducing face-to-face time. We look to their schedules and patient interactions, supported by RTLS data, to see how long they typically spend with patients. Based on their balanced average, we were recently able to roll out an enhanced scheduling model. Some providers follow three 20-minute visits, then 20 minutes off. Some follow four 30-minute visits, then 15 minutes off. Through the data, we can better understand how much time they actually spend with patients and how best to organize their day, so they can increase patient throughput without sacrificing quality care.

    Clearer visibility to the patient experience

    Our clinics are full-service. From labs to specialists, we have multiple staff members providing collaborative care in a single exam room. To be successful with this model, real-time location information is critical. Our teams use a dashboard, displayed either in a map or list view, to determine where they are going next, which patient they are attending to, what is the next step in the patient visit or which rooms are available. It’s this direct but passive communication that reduces time spent looking or asking others for information. Leveraging RTLS technology for patient and room status information resulted in one of our clinics decreasing rooming time by 10% and reducing the overall patient visit length by 8%.

    Accurate contact tracing

    While contact tracing has tapered off some since the COVID-19 pandemic began, we do use the real-time location information to identify potential exposure to contagions. Thanks to the RTLS badges, we’re able to identify if a contagious patient shared space with another patient, which exam room the contagious patient was in and for how long, and which staff members were exposed and for how long. The accuracy of this information allowed us to follow appropriate safety procedures at the height of the pandemic. It’s still used today for other contagions such as tuberculosis and even bed bugs.

    Across my 22 primary care providers who serve more than 37,000 patients, it is my goal to optimize performance and improve experiences for everyone at the point of care. It’s a two-pronged approach where we focus on solving multi-faceted problems with a single solution. Through the power of RTLS data, our providers have been able to increase capacity — one as much as 15%, or an additional 86 visits per month — while maintaining the same amount of face-to-face time. Our room utilization rate is between 85% and 90%, and our patient satisfaction scores are in the 90th percentile. The technology we use to capitalize on workflow efficiency amazes our new providers. They are continuously impressed with how streamlined and effective our practices are, and yet collaborative at the same time. My providers and staff are really proud of our care model and what we’ve been able to accomplish with technology. It sets us apart in the eyes of patients and distinguishes us as a place where providers and staff like to work.  

    If there’s one final thought I have for my fellow clinic or practice managers, it’s this: only after a deep sweep of processes can you determine where extra capacity and revenue lies. How deep you get into your processes depends on how rich your data is.  

    The improvements my clinics gain from RTLS data, both real-time and historical, have paved the way for innovation within the Aurora Health Care family. What started as a couple clinics with RTLS, self-rooming and collaborative care has now grown into a repeatable model anchored on RTLS technology. We believe in the power of technology and data, and in collaboration with our RTLS partner, we continue to transform healthcare operations for the better.

    To learn more about my experience and success with self-rooming and RTLS, register for my MGMA-hosted webinar where you will learn more about:

    • Developing stronger room utilization and hidden revenue opportunities through data
    • Revising communication and workflow bottlenecks through a data-enriched workflow
    • Creating a culture where staff believe in the benefits and efficiencies gained in a self-rooming model supported by RTLS technology.
    Elise Dieringer

    Written By

    Elise Dieringer, BSN, RN

    Elise Dieringer, BSN, RN, is the Manager of Clinic Operations at Aurora Health Care, the third largest nonprofit health system in the country. She has 15 years of clinical experience, ranging in primary care, pediatrics, oncology and cardiology. Her clinical background has led to her ability to successfully lead effective care teams. From embracing technology to creating the clinic of the future, Elise is a forward-thinker and has an eye for optimizing operations.

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