Peer Review

PROJECT TOPIC

Ophthalmology Clinic

PREPARED BY DATE

Amanda Greer

February 28, 2022

OVERVIEW OF THE ORGANIZATION

(Item 1)

· Mission: To provide patients with the best gift of them all, the gift of sight and provide patients with the best care and knowledge on their eyes.

· Vision: To be the top ophthalmology clinic in the metroplex.

· Services provided: eye treatment, medication, eye corrective surgery, eyelid surgery, glasses, and contact lenses. Patients with glaucoma, cataracts, diabetic retinopathy, chalazions/styes, low vision, drooping eyelids, facial spasms, and eye infections are all treated at this facility.

· Our patients range in age from 6 to 90+ and we accept most health insurance to insure the majority of patients are getting the care they need.

· This clinic sees approximately 30,000-40,000 patients a year and about 20,000 eye surgeries are performed each year

IDENTIFIED PROBLEMS

(Item 2)

· Long in office times effecting patient satisfaction

· Cost of care – too expensive

· Favoritism through the office – impacts patient care, sales, office morale

SOLUTIONS

(Item 3)

· Decreasing wait time and spreading out patient appointment times in order for the patient not to have to wait for doctor for too long.

· Lowering prices of the exam, sales products, and diagnostic testing

· Change leadership and have even playing field for everyone

MEASURABLE PROJECT GOALS

(Item 4)

· Lower cost of at least 2 diagnostic tests and the refraction cost

· Focus on a specific type of exam and minimize those in office times

· Establish an even playing field within the office

· The plan is to have these goals fully reached or even noticing significant change by October 2022.

OBSTACLES

AND

OPPORTUNITIES

(Item 5)

· Obstacles: increase in prices, unacceptable insurance, employees being reluctant to accept changes, uneducated employees

· Opportunities: improved patient and employee satisfaction, increase in sales

STRAGETIC (or ACTION) PLAN

(Item 6)

· See Appendix below

CONCLUSION

REFERENCES

Sommer, A., Blumenthal, E. Z. (2019). Implementation of Lean and Six Sigma principles in ophthalmology for improving quality of care and patient flow. Public Health and the Eye, 64(5), 720-728. https://doi.org/10.1016/j.survophthal.2019.03.007

Ciulla, Thomas A., Tatikonda, Mohan V., ElMaraghi, Yehya A., Hussain, Rehan M., Hill, Amanda L., Clary, Julie M., Hattab, Eyas. (2018). Lean Six Sigma Techniques to Improve Ophthalmology. The Journal of Retinal and Vitreous Diseases, 38(9), 1688-1698. doi: 10.1097/IAE.0000000000001761

Hribar, A., Read-Brown, S., Goldstein, I.H., Reznick, L.G., Lombardi, L., Parikh, M., Chamberlain, W., Chiang, M.F. (2018). Secondary use of Electronic Health Record Data for Clinical Workflow Analysis. Journal of the American Medical Informatics Association, 25(1), 40–46. https://doi.org/10.1093/jamia/ocx098

Davis, A.S., Elkeeb, A.M., Vizzeri, G. et al. Utilization of Portable Radios to Improve Ophthalmology Clinic Efficiency in an Academic Setting. J Med Syst 40, 64 (2016). https://doi.org/10.1007/s10916-015-0417-x

Lin, C., Li, A., Ma, H., Lin, X.M., Olivares, M.Z., Haubrich, A., Sanislo, S., Do, D.V. (2021). Successful interventions to improve efficiency and reduce patient visit duration in a retina practice. Retina, 41(10), 2157-2162. doi: 10.1097/IAE.0000000000003169

Ma, J., Wong, B.M., Micieli, J.A., Calafati, J., Low, S., El-Defrawy, S., Hatch, W. (2020). Vision to improve: quality improvement in ophthalmology. Canadian Journal of Ophthalmology, 55(2), 107-115. https://doi.org/10.1016/j.jcjo.2019.07.020

Avidor, D., Loewenstein, A., Waisbourd, M. et al. Cost-effectiveness of diabetic retinopathy screening programs using telemedicine: a systematic review. Cost Eff Resour Alloc 18, 16 (2020). https://doi.org/10.1186/s12962-020-00211-1

Goals

Required Tasks

Individuals involved

Resources Needed

Timeline

Measurements

1. Decrease in office time

1. Get medical history prior to the visit

2. Verify insurance prior to the visit

3. Add more details to patient’s chart as to why they are in office

4. Call patients prior to exam to gather more information.

Ophthalmic technicians, doctors, receptionists

Insurance, patient cooperation

2/2022 to 10/2022

Time documentation

2. Decrease cost of care

Lower cost of diagnostic testing, glasses, contacts, surgery

Billing, CEO, office management

Competitor prices, equipment pricing

2/2022 to 10/2022

Billing information, spread sheets, patient surveys

3. Decrease favoritism

1. Team meetings

2. Possibly change in management

3. Equal work share

Management, doctors, ophthalmic technicians

Cooperation from all staff

2/2022 to 10/2022

Monthly meetings with individuals and as a group