Friday, June 26, 2009

Blue Skies

Great week!

Not because of this:

Our 3rd NAA is showing some improvement, but I’m not paying that much attention to it since I decided that “slow but steady” is going to win this race (see last post). We also discovered a measurement glitch last week. We use an electronic scheduling system and calculate the 3rd NAA using a “find next available appointment” feature. Last year we changed the way we use our electronic scheduler, to give doctors access to their surgical schedule via our EMR. We recently realized that this affected the way the program was identifying the next available appointment slot. The electronic result for 3rd NAA is slightly longer than the manually calculated 3rd NAA. This is a measurement artifact that will show up as a small drop in 3rd NAA as we start recording wait times calculated manually. It doesn’t change our patients’ experience of wait times.

No, the great thing about this week was a sign of a culture shift in our practice. We’ve been working to reduce our recall rates, in order to improve our capacity. In May, two of our partners had recall rates in single digits – down from their previous rates of around 20%. What happened?

At our office meeting this week, the two shared their insights into recall practices. There were common themes:
  • Think each time you plan to recall a patient: Is an office visit absolutely necessary? What are the alternatives?
  • When returning care to the family doctor, provide the patient and family doctor with recommendations for follow-up testing and examinations, along with the results that trigger a review by a urologist.
  • Reassure the patient that we will be available for consultation should their condition warrant it

“I want to function as a consultant” was the main point. They also noted that most patients had been pleased to be able to have follow-up provided by their family doctor, and thereby save a trip to Saskatoon.

However, several urologists pointed out that access to family doctors remains a problem, especially in rural Saskatchewan. In those situations, we would continue to provide appropriate follow-up, either in person, or by telephone or mail.

Great job, docs! This makes a very nice start to the summer.

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