Advanced Nurse Practioners Physician Assistants RENE VALLEJO MBA

Advanced Nurse Practioners Physician Assistants RENE VALLEJO, MBA TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER EL PASO, DEPARTMENT OF SURGERY ASSOCIATION OF ACADEMIC SURGICAL ADMINISTRATORS OCTOBER 23, 2017

Introduction / Problem Ø Wait times are one of many patient satisfaction indicators Ø Patients wait time are NOT at an acceptable level in academic surgical clinic Ø Balancing teaching and non-teaching encounters Ø Who determines this time? o Practitioners participating in clinic? o Administration? o Patients?

Introduction / Problem Ø Strive to provide care that is: o High quality o Cost effective o Comprehensive o Timely Ø Academic setting pose an added challenge to keep times at an acceptable level Ø Change can be a difficult process to overcome Ø Culture change “WE HAVE BEEN DOING THIS SINCE……”

Question Ø How to reduce wait times for Adult surgical patients in an academic surgical clinic? Ø Does implementation of a single decision making practitioner affect the teaching experience of medical students and residents? Ø What is the balance between single decision making practitioner versus traditional academic set-up? Ø Can a single decision making practitioner impact overall patient satisfaction outcomes?

Evidence Based Practice Measures Ø Single point of contact practice setup Ø Decrease interactions that in turn decrease times Ø Efficiency Ø Improve access to care

Outcomes of Project Reduction in wait times from registration to exam by “decision making practitioner” Average Wait Times in Minutes 120 108 44% 100 80 60 51 40 20 0 Physician APRN

Added Benefits Ø Reduction in Time to 3 rd Appointment (time from referral to appointment with specialist) o Initial 48 days o 3 months 11 days o 6 months within 8 days Ø Reduction in chronic follow-up patients in faculty clinic o Increased numbers of new patients referrals o Increase teaching opportunities for students o Increase access to care o Increase in Surgical Yield

Evaluation of Measures Implemented Ø Single point of contact clinic o Decreased wait times by 44% o Increase access to care o Reduced Time to 3 rd appointment Ø Absence of negative feedback

Questions?