MHA-FPX5042 Assessment 4

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Capella University *

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MHA 5042

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Health Science

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Dec 6, 2023

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docx

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1 Team Development Analysis Beth Doeden Capella University MHA-FPX5042 Team Dev Pers Leadership Health Care May 4, 2021

2 Introduction To improve finances within my healthcare organization, each department has a margin enhancement project to increase revenue or improve finances. For my department in Urgent Care, we were tasked with increasing our hours of operation. The need for same-day non-Emergent Care extends past the current Urgent Care hours of 9 am to 9 pm, and these patients must either wait for Urgent Care to open or go to the ETC. The cost/benefit of extending Urgent Care hours to meet the needs of additional patients needs must be discovered, and a group has been charged with evaluating the opportunity. Urgent Care is staffed daily for operating hours of 9 am to 9 pm every day of the year. Urgent Care staffing includes a core staff of Providers, RNs, LPNs/CMAs, PCEs, and Urgent Care, who are scheduled to work the 12-hour shift. The staff has a rotating Holiday and weekend schedule. Urgent Care relies on the collaborative work of many other departments to care for patients, including Lab, Imaging, and Pharmacy, which must also staff appropriate hours for Urgent Care operations. These departments also have earlier weekday operating hours to serve other Plaza clinics. Urgent Care sees approximately 150 patients daily, although this average varies significantly with seasonal demand. Patient volume is generally highest in the AM, with lines frequently forming before 9 am for patients who want to be seen as early as possible. Arrivals slow down after 7 pm, resulting in fewer patients arriving from 8 pm to 9 pm. Urgent Care currently employs two practices, Diversion and Pause, which serve as patient limitations when the Charge RN or Manager implements them. Diversion limits patients to non-complex symptoms. This aims to increase patient turnover to see a large volume of

3 patients during high-demand times and prevent many low-acuity patients from seeking services elsewhere. Diversion is communicated to stakeholders with a standard list of symptoms this determination affects. Pause ceases all check-ins of new patients. This is often implemented in the late afternoon or evening on days of exceptionally high demand when the wait time to room a patient exceeds the time remaining before closing. For example, if there are 50 patients currently in the lobby at 7 pm with an estimated 2.5hr wait, the Charge RN may call a Pause. Additionally, patients who arrive later in the evening may be asked to seek care elsewhere or return in the morning if their symptoms and triage indicate that the workup necessary for this patient will significantly exceed the time remaining before closing. The ETC sees an increase in low acuity patients from 7 pm to 9 pm, coinciding with the decrease at Urgent Care. The group assesses that this results from patient uncertainty about whether they will or will not be able to be seen in Urgent Care during this time. The impression that patients have those late evening arrivals in Urgent Care are "risky" is likely driving both the lower volumes in Urgent Care and the higher non-urgent volumes in the ED during these evening hours. The group determined that clarity in the message to the community would be vital to bringing these patients back to Urgent Care.

4 To combat the perception of the community that is causing the lower evening URGENT CARE volumes, the group determined that efforts should be undertaken to restore confidence. The first would be redefining operating hours when publicized to the community. The group assessed that the best way to define this would be "Check-ins Reliably Accepted" during this time. Under the current staffing, this time was determined to be 8 pm. This would allow long workups and wait times to be completed before the staff's scheduled shift ends. The expectation is that this will also decrease the frequency of using Pause and Divert. It was determined to use this definition in planning for extended operating hours and in a communication push to advertise any changed hours and increase confidence in Urgent Care. The group determined that expanding into the earlier morning hours during weekdays would be the easiest to achieve without additional full-time employees and recruiting to fill positions because of the existing staffing in imaging, lab, and pharmacy to support the other clinics. Only the core Urgent Care staffing model would need to change in this scenario. With the recent change to a mode of team-based staffing in Urgent Care, additional hours could be

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