Rheumatologists encounter time constraints comparable to primary care providers but have not benefited from optimum team-based rooming from the moment the patient enters the waiting room until the rheumatologist enters the room. For this study, researchers wanted to analyze existing population management capabilities in rheumatology clinics; we wanted to quantify the duties done by rheumatology clinic staff (medical assistants or nurses) during rooming. During 2014–2015, they conducted a cross-sectional study and work-system analysis to assess rooming processes at three rheumatology clinics in academic multispecialty practice. Using the Fisher exact test and analysis of variance, they computed descriptive statistics and compared frequencies and durations.
They discovered several significant variances in 190 rheumatology clinic pre-visit rooming sequences (1,419 minutes) after observing 190 rheumatology clinic pre-visit rooming sequences. The total length of rooming differed by the clinic (median, 6.75–8.25 minutes; p < 0.001). More than half of the rooming time was spent on vital sign monitoring and medication reconciliation. Two of the 15 activities differed considerably in duration while 9 varied in frequency across three clinics. Clinic officials changed rules and processes to streamline the evaluation of weight, height, pain ratings, cigarette use, disease activity, and refill needs based on the findings.
Examining rheumatology rooming duties revealed the important potential to increase quality and efficiency while minimizing provider stress. The study presented user-friendly approaches for identifying possibilities for standardization of rooming and supporting data-driven decisions on rheumatic clinic practice adjustments to improve population management in rheumatology.
Reference:journals.lww.com/jclinrheum/Abstract/2019/04000/Assessing_Unwanted_Variations_in_Rheumatology.5.aspx
