Hanscom applies AFSO21 principles to improve patient access Published Oct. 10, 2007 By by 1st Lt. Lisa Spilinek 66th Air Base Wing Public Affairs HANSCOM AIR FORCE BASE, Mass. -- "What is better for the patient?" was the question that was asked repeatedly during the 66th Medical Group's three-day Air Force Smart Operations for the 21st Century workshop held here Oct. 3-5. The event focused on the flow of primary care patients through the Hanscom Clinic, a process that has been challenging for the clinic, said 66th Medical Group commander Lt. Col. Jay Cloutier. The Hanscom Clinic is the only military treatment facility in New England available to Armed Forces active-duty, Reserve and retired service members as well as their dependents. Currently, there are 7,701 beneficiaries enrolled at the clinic who are treated by six primary care providers. Facing Program Budget Decision 720 manning cuts that could further impede patient care access, a team of five clinic personnel began meeting with Maj. Joe Heilhecker, Secretary of the Air Force AFSO21 Office, in July and became certified in AFSO21 Level I training to prepare for the AFSO21 workshop. "The thing with AFSO21 is that it's not a separate program, it's a set of tools to use to find solutions," Major Heilhecker told the team while encouraging them to find solutions to patient access problems rather than reorganizing broken processes. To generate data regarding patient care, 66th Medical Group AFSO21 facilitators Tech. Sgt. Jennifer Tierney and Tech. Sgt. John Carbon followed 14 Hanscom patients throughout the course of their visits to the clinic to document the time it took for patients to be seen by care providers. The sergeants found that patients spent an average of 28 minutes waiting to be seen by the doctor or medical technician and to receive care at the clinic's ancillary offices such as the pharmacy or immunizations clinic. The AFSO21 facilitators then paired up with one of the Hanscom Clinic's primary care provider teams to address issues surrounding patient access by examining the current state of affairs at the clinic and comparing it with an ideal state. Then the group mapped out a future state to implement within the next six months for the way clinic patients would be seen. The primary care team of Dr. (Maj.) Anthony Ciampa, Capt. Linnea Collins, medical technicians, Tech. Sgt. Wilmon Cullers and Airman 1st Class Aaron Jones as well as Staff Sgt. Brendan Fagan, who oversees the team's administrative processes, provided valuable information about the way they see patients and how the process could be improved by reducing or eliminating wasteful, non-value added steps. As a result of their discussions with the AFSO21 facilitators, the following areas will be addressed by the clinic staff within the next three to six months: > Streamlining the patient check-in process so that patients have one check-in point instead of two > Creating appointment templates to hasten the appointment booking process; streamlining the patient referral process by creating a patient referral desk > Addressing computer log-in processes that currently allow only one person - the doctor or a technician - to use a computer in an exam room at a time, which results in clinic personnel spending up to two hours each day logging on and off computers > Standardizing the supplies kept within each exam room to reduce the number of times medical technicians need to leave a patient to hunt down supplies According to the two observers who traveled to Hanscom for the AFSO21 workshop, Lt. Col. Tim Kosmatka, Air Force Medical Operating Agency South Air Force Family Medical Services chief consultant, and Lt. Col. Barbara Anderson, AFMC Office of the Surgeon General Healthcare Optimization chief, Hanscom's problems are not unique. "Seeing issues at Hanscom is a forerunner to address issues that we are experiencing Air Force-wide. The ultimate goal is to use the lessons learned here and apply them to the rest of the [Air Force Medical Service]," Colonel Anderson said. By making changes at the Hanscom Clinic to reduce patient wait times and streamline processes, clinic personnel ultimately hope to reduce patient exam times. "If we can shave time off of each patient, how many more patients can we see? How many more walk-ins can we fit in without feeling stressed?" Colonel Cloutier asked. Added Colonel Kosmatka, "The true measure of patient access is, how many times when the patient called for an appointment were they able to get one?"