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NMRTU Everett staff collaborate to ensure Patient Centered Care

Image of two military personnel wearing masks. The eyes have it...Lt. Courtney Rafferty (standing) and Hospital Corpsman 2nd Class Veronica Vargas of Navy Medicine Readiness and Training Unit (NMRTU) Everett Optometry clinic, along with Mr. Cheryl Miller (not pictured) were commended for modifications made to reduce patient wait times and enhance patient centered care by the Military Health System (MHS) 2020 Advancement towards High Reliability Healthcare Awards Program as a Patient Centeredness Award winner (Official Navy photo).

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Most people don’t enjoy sitting in a waiting-room waiting for their doctor’s appointment.

Due to response to the COVID-19 pandemic, patients seeking routine eye exams through Navy Medicine Readiness and Training Unit (NMRTU) Everett’s Optometry clinic were experiencing wait times upwards of 30 minutes prior to being called back to the examination room. 

However, through some creativity and ingenuity, the clinic has reduced patient wait time by 87% and increased access to care by 51.4% over the past six months.

The modifications implemented to increase access to care and shorten wait times resulted in NMRTU Everett being commended by the Military Health System 2020 Advancement towards High Reliability Healthcare Awards Program as a Patient Centeredness Award winner.

This recognition program annually recognizes initiative and commitment to the development of systems and processes to help MHS advance into a high reliability organization ensuring safe, reliable care for all patients and their families, promoting a culture that encourages learning, sharing, and continuous improvement. 

“I’m still in shock and humbled our project was selected for the award. I think it signifies that even at a smaller branch health clinic with fewer resources, including staff members and clinic space, there are always opportunities to take ownership and allow staff the creativity to challenge the culture of accepting things as ‘good enough,’” said Navy Lt. Courtney Rafferty, NMRTU Everett Optometry head and team lead for the clinic project entitled, ‘Increasing Access to Care and Minimizing Patient Wait Time to Enhance Healthcare Efficiency and Improve Patient Satisfaction.’

“Cheryl Morris, our Clinical Support Services receptionist, is incredibly helpful and always willing to try new things, keeping track of all the various requirements not only for Optometry but also Physical Therapy and Mental Health,” Rafferty said. “Hospital Corpsman 2nd Class Veronica Vargas has been an incredibly dedicated member of the team. She is the only optician at the clinic and she has developed a level of expertise within Optometry over the past year tantamount to fourth year Optometry externs. Her curiosity and willingness to learn and make suggestions has been essential in our patient care efficiency and implementing new suggestions for continuous process improvements.”

Rafferty also cited Navy Hospitalman 2nd Class Abhiram Nair from the radiology department, who volunteered to assist in the Optometry clinic project.

“HM2 Nair and HM2 Vargas receive countless compliments from patients for their professionalism in customer service. We were also lucky to have Hospitalman Rachel Doyle from Medical Home Port who provided assistance and developed additional improvements like color-coding several hundred contact lens trials to prevent any defects. Lieutenant Commander Cameron Mathie also assisted in providing information for data collection and ideas for improving templating in increasing access to care,” added Rafferty.

Using the business improvement methodology of Lean Six Sigma to promote patient centeredness, Rafferty and her team not only improved overall patient-care, but also enhanced patient and staff satisfaction, while increasing efficiency and delivery of care.

Rafferty affirmed that understanding that patient wait times and access to care are two of the most significant components of overall patient satisfaction rates in health care. Striving to improve the patient’s experience is at the heart of patient centeredness in a high-reliability organization.

“While there is a general consensus that access to care is a valuable metric to track, many may not concede that patient wait times are as critical to monitor. Many studies found that patient wait time was the single biggest indicator for patient satisfaction outcomes in healthcare, regardless of how satisfied the patients are with the provider or care received. Additionally, reducing wait times for patients while increasing access to care requires a look at the efficiency of every single step involved in a patient’s flow through the clinic, so it challenges the staff to find opportunities at every step to improve efficiency,” Rafferty explained.

An unintended consequence of the improvement project was that it also supported the clinic’s response to the pandemic.

“Our project preceded the pandemic outbreak, but proved critical during COVID-19 in mitigating exposure by preventing patients from spending time in the waiting room shared with physical therapy and behavioral health,” Rafferty said. “The steps we took to improve the overall efficiency had the benefit of maintaining minimal patient exam flow times."

  “This project did not end when we submitted it,” Rafferty stated. “We continue to move forward and try new things. I’ve been incredibly lucky to work with sailors who have demonstrated a willingness to suggest new ideas and take risks to find solutions where others may not even see a problem. I am incredibly proud that HM2 Vargas and the sailors have provided additional assistance. Regardless of rate or rank, continuous small changes over time can make a significant and meaningful difference.”

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