IngentaConnect Using Patient Traffic Control to Reduce Treatment Delays for High...

Authors: Schmitt, Brian P.; Hoffstadter, Lynn; Greider, Sandra; Thomas, Kitty; Calubaquib, Estrella; Montgomery, Edna; Robinson, Gail; Guay, Bruce; Bhoopalam, Nirmala; Temeck, Barbara

Source: Joint Commission Journal on Quality and Patient Safety, Volume 34, Number 3, March 2008 , pp. 147-153(7)

Publisher: Joint Commission Resources

Abstract:

Background: For patients at high risk of function-limiting or life-limiting disease, the time elapsed between first clinical presentation, diagnosis, and treatment can influence the likelihood of treatment success.

Methods: A systematic change in the management of high-risk patients was undertaken. This approach includes identifying primary provider responsibility, establishing communication expectations between providers, developing a tracking system to actively monitor patients (patient traffic control), and using a time guideline to assess patient progression. A 60-day time frame was established for the time from first clinical presentation to diagnostic exclusion or treatment initiation.

Results: In a one-year period, 288 high-risk patients were entered into patient traffic control, 211 (73%) of whom were monitored in the primary care setting. The median time to diagnostic exclusion or treatment was 43 days (mean, 58.5 days). Sixty-six percent of all patients achieved diagnostic exclusion or treatment by 60 days. Of the 95 patients monitored for > 60 days, 56% had delays caused by patient noncompliance or because of the appropriate need for long-term serial radiographic monitoring. Thirty-eight patients (13.1%) demonstrated problems with appointment nonadherence. None were lost to follow-up.

Discussion: The patient traffic control approach enabled the management of the majority of high-risk patients within 60 days of presentation.

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Using Patient Traffic Control to Reduce Treatment Delays for High-Risk Patients at a VA Hospital