Timestudy Tips

Tue, 10/13/2015 - 13:21 -- gkroberts

Hi, I am currently working on a QI project to decrease patient wait times in one of our health departments. I have not personally done a timestudy before, and was wondering if anyone could provide some useful tips on how to approach doing this to get baseline and post-implementation data?

I was trying to be considerate of clinic staff by keeping this the least invasive as possible. Someone suggested using a colored index card to write down the times that the patient/chart reaches certain checkpoints. Does anyone have any experience with this that could provide advice?

Thank you!

up
0 users have voted.

larena's picture
Submitted by larena on

Hi Gurleen,

I'm interested to hear what others in the community have done too! We do have one initiative that mentions conducting three time studies to measure reduced wait times. The submitter will receive a notification if you post a comment on the initiative so you could ask for more information about how they conducted their time studies. Here's a link to the initiative: 

https://www.phqix.org/content/decreasing-wait-times-reproductive-health-clinic

up
0 users have voted.

Laura Arena, MPH
PHQIX Communications Lead
RTI International
contact@phqix.org

Submitted by johnshutze on

My advice is to go for it and make it a self-learning opportunity. Try not to over think it to the point that it gets in the way of progress. Try the index card idea and see where that takes you. You could use the index card idea for one day, evaluate it, and make changes as needed. Use the Plan-Do-Study-Act thought process.

No matter how you do this, it will probably be a little awkward, so open communication with the staff is key. Also, you'll want to keep the measurement process consistent for baseline and post-implementation.

We've tried a couple ways to measure wait time.

  1. Directly Observe the Process - this might be uncomfortable at first. Being open and talking with the staff about it seemed to relax things a little. 
  2. Patient Logs the Time - there's a simple form given to patients at check in where they log the time at pre-determined points in the process. It might seem like you're shifting some responsibility to the patient (and your are), so you'll need to be selective in which patients you ask to do this, and it's importatnt to communicate that their assistance will have an impact.

Hope this helps!

up
0 users have voted.

Submitted by gkroberts on

Laura, thank you for this tip! I posted a question on that submission and will link the answer once I receive it.

John, thank you for sharing your experience. I appreciate your advice, especially the "patient logs the time" approach. I think this would address my concern about using the index card approach and allowing staff to self-report the time (which could be fabricated). I will probably do a direct observation, with the index card approach and allow the patient to play a role in the data collection. I'll let you know how it goes!

up
0 users have voted.

Gurleen Roberts, MPH
Director of Quality Management
Cobb & Douglas Public Health
Marietta, GA
gurleen.roberts@dph.ga.gov

Submitted by gkroberts on

Update: We did two days of baseline data collection this week. I discussed the time study approach with a few QI experts and decided to shadow one patient at a time from the moment they walk in to the clinic until they leave. We created a tracking form, based on the process map, to keep track of the time at various steps of the process. On the back of the form, I created a map of the facility (spaghetti diagram) to be used to track the motion each patient makes through their visit. I would be happy to share this form with anyone so feel free to email me.

Pros of this approach: accurate time measurements, reliable data, well-rounded picture of the time it takes different services and employees in each step, patients are happy to participate and enjoy the opportunity to share their experience (even if you don't ask them to share).

Cons of the approach: time-consuming, did not have a high quantity of data points because of how long it took each patient (I did 4 the first day and 8 the second), tedious, need multiple data collectors.

Tips: We brought the staff a breakfast snack the first day to thank them for allowing us to observe and I really think this set a comfortable tone for everyone involved. Also, make sure to pack snacks and water to carry with you because we got hangry after a few hours. We are also planning to do a surprise visit next week to get a few more data points to ensure that the first two days were not set-up because the staff knew we were coming. Lastly, we used our phones to track the time since all of our phones have the same time.

So far, we are happy with this approach. I will update you all again after post-implementation time studies.

up
0 users have voted.

Gurleen Roberts, MPH
Director of Quality Management
Cobb & Douglas Public Health
Marietta, GA
gurleen.roberts@dph.ga.gov