Observational study to determine predictors of rheumatology clinic visit provider contact time.

OBJECTIVE

To address perceived inefficiencies in an academic rheumatology practice, a timing/work-flow evaluation was initiated to determine the factors that predict the provider contact time (PCT), i.e., the amount of time that attending physicians spend with patients during an outpatient encounter.

METHODS

This prospective observational study was conducted at the University of Colorado Hospital Rheumatology Clinic for return patient visits in early 2008. Each patient encounter was subdivided into components, and the time for each component was recorded. Up to 20 return-visit encounters per provider were randomly selected for inclusion. Multivariate linear regression was used to predict the time, in minutes, that providers spent with patients, and logistic regression was used to determine the time intervals associated with the patient's perception that the visit ran on time.

RESULTS

Variables associated with increased PCT were whether a procedure was performed in the clinic (P = 0.037) and whether the visit occurred in the afternoon (P < 0.025). For every minute a provider was late in beginning to see a patient, the PCT decreased by 0.32 minutes (95% confidence interval [95% CI] 0.15, 0.49). Variables associated with the patient's perception that the visit ran on time included the check-in to vitals delay (odds ratio [OR] 0.95; 95% CI 0.92, 0.99) and the provider delay (OR 0.92; 95% CI 0.86, 0.99).

CONCLUSION

The patient's punctuality and the presence of a resident are not significantly associated with the time that a provider spends with a patient. However, the degree to which the provider runs late was associated with decreased PCT and diminishes the patient's perception that the visit is running on time.