About Redesign

There's a lot for patients to dislike about going to see the doctor these days. It often begins with the frustration of an impersonal, incomprehensible auto-attended phone system and being put on hold when the patient finally reaches a real person.

Then there's the interminable waiting—for a convenient and timely appointment, for registering after arriving for the appointment, as well as the big wait before seeing the clinician (finally!). All for fifteen minutes of face time with the doctor, on average, who is trying hard to listen but is frequently interrupted by other staff and distracted knowing that other patients are waiting to be seen.

But it doesn't have to be this way. It's not just patients who are frustrated. Clinicians are frustrated by processes and systems that stymie their quest for quality patient care. Clinic staff members are numbed by all the rules, policies, procedures, forms, papers, and hierarchy that stifle creativity and individual effectiveness.

Patient Visit Redesign is about work process design and teamwork. It is focused on the end-user of your services—the patient—though the benefits of redesign are reaped by the staff and the organization as well.

The goal of redesign is to virtually eliminate patient waiting. Redesign requires you to look at the way you accomplish work with a fresh perspective, starting from scratch to recreate a patient visit process that is efficient and above all patient-focused.

It is best to think of redesign (or reengineering) not as an "improvement methodology", but rather as a method that seeks to transform the patient experience, the health care workplace, and the organization as a whole.

A transformed patient experience means easy access to care, minimal waiting time during visits, and a significant drop in clinical errors (i.e., patient safety). A transformed workplace is an exciting place to work where learning is optimal, teamwork the norm, and everyone can work to her/his full potential. And, a transformed organization is optimally productive, financially healthy, technologically savvy, and hierarchically flat. Such an organization adapts quickly and well to change.

Why redesign?

• Because patients complain they spend too much time waiting.
• Because your best staff are frustrated by the current systems and processes.
• Because your productivity is lackluster and does not improve significantly.
• Because teamwork is rare rather than the norm.

A better question to ask might be: Why not redesign?

The redesign methodology is conceptually simple, but very difficult to implement. There are seven key steps:

• Direct observation of patient experiences in real time. This technique is profoundly illuminating, yet simple to do. You should directly observe and document ten to twelve patient visits. See how to start for more information.
• Translate the trackings into graphic representations ("mappings"). This technique allows you to see the dysfunctional patterns of your current visit process. You may feel you know what's wrong already, but you'll find you're partially right and partially wrong in your assumptions. See how to start for more information.
• Gather baseline cycle time and productivity data.
• Create an ideal visit model. This will be your destination for your journey of redesign and it takes only 20 minutes to complete. See success stories for more information on this exercise.
• Test the visit model in a series of eight tests that begin with three hour clinic sessions and then extend to all day sessions. After each test, debrief thoroughly and refine the model.
• After the tests, determine your final patient visit model, and run it for three full days, gathering cycle time and productivity data to measure your results and compare to your baseline data.
• Implement your final model across your clinic site. By this time, you have some staff eager to try the new. Not everyone will be excited by the prospect of impending change, but even these folks will agree with the new way of working once they have some experience with it (and are reaping the benefits.)

This website is designed to help those interested in Patient Visit Redesign™. If you are interested but unfamiliar with redesign, read the articles in the success stories section and do the exercises outlined in the how to start section and read a book or article listed under more resources.

If you have substantial experience with redesign, the key website areas of interest to you will be techniques, team culture, and more resources.

We hope you find the contents of this website beneficial and inspiring. We also hope you join us in the movement to redesign the patient experience so that we all provide the level of care and service our patients deserve and our staff members want to deliver.