Kronlage René Marcella, Stanley Amy S, Reid Miranda J, Shaw William Hudson, House Cara E, Lossius Michele N, Kulla Artenisa, Coxen Kendyll, Mackie Phillip M, Holland Carolyn K
University of Florida College of Medicine, Gainesville, Florida, USA
University of Florida College of Medicine, Gainesville, Florida, USA.
BMJ Open Qual. 2024 Oct 2;13(4):e002951. doi: 10.1136/bmjoq-2024-002951.
The University of Florida (UF) Equal Access Clinic Network (EACN) is the largest student-run free healthcare clinic network in Florida. The UF EACN serves those who are underinsured or uninsured in Alachua County and its surrounding area. Nationally, average total clinic time per medical visit has been established to be 84 min.
Before this project, average patient cycle time at the UF EACN was 125.3 min, and there was no established quality improvement (QI) team to implement changes to address inefficiencies.
This was a prospective QI study that recorded patient cycle times for patients who received healthcare at any of the four primary care free clinics across the UF EACN from 5 July 2022 to 6 April 2023.
Eighteen Plan-Do-Study-Act cycles were tailored to each of the four primary care clinic's needs with a focus on reducing patient cycle time by addressing the following identified problems: prolonged intake process, translation services, limited numbers of volunteers, and other inefficiencies and bottlenecks in workflow.
The median patient cycle time at the EACN shifted from 125.3 min to 112.7 min over a nine month period. This drop of 12.6 min meant patients saw a 10.1% reduction in patient cycle time across the EACN.
Underserved patients at EACN are experiencing increased value by having shorter patient cycle times.
佛罗里达大学（UF）平等医疗诊所网络（EACN）是佛罗里达州最大的由学生运营的免费医疗诊所网络。UF EACN为阿拉楚阿县及其周边地区未充分参保或未参保的人群提供服务。在全国范围内，每次就诊的平均总诊疗时间已确定为84分钟。
在这个项目之前，UF EACN的平均患者周转时间为125.3分钟，并且没有成立质量改进（QI）团队来实施变革以解决效率低下的问题。
这是一项前瞻性QI研究，记录了2022年7月5日至2023年4月6日期间在UF EACN的四家初级保健免费诊所中任何一家接受医疗服务的患者的周转时间。
针对四家初级保健诊所各自的需求，量身定制了18个计划-实施-研究-改进循环，重点是通过解决以下已确定的问题来减少患者周转时间：冗长的接诊流程、翻译服务、志愿者数量有限以及工作流程中的其他效率低下和瓶颈问题。
在九个月的时间里，EACN的患者中位周转时间从125.3分钟降至112.7分钟。这12.6分钟的降幅意味着整个EACN的患者周转时间减少了10.1%。
EACN中服务不足的患者因患者周转时间缩短而获得了更高的价值。
