Impact of a Checklist on Clinic Flow and Patient Visit Times at a Student-Run Free Clinic
Abstract
Background: While student-run free clinics are a valuable resource to the community, there are limitations leading to challenges with clinic flow. Previous research has identified checklists as a useful intervention in medicine. This project sought to evaluate the efficacy of a checklist on student volunteer accuracy and adherence to clinic flow, and patient visit times.
Methods: From June 2019 to February 2020, volunteers at select clinics received a checklist listing important steps of a patient encounter. The authors sent surveys to volunteers following all clinics and recorded patient visit times. The outcomes measured were: volunteer accuracy (number of steps completed); volunteer adherence (order of steps); perceived helpfulness of the checklist; and patient visit times. The first three outcomes were assessed via self-reported survey data and the last outcome was assessed via collection of time data. Fisher’s exact tests to assess statistical significance (p<0.05).
Results: Thirty-eight student volunteers completed surveys, for a response rate of 67.9%. Eighteen (47%) of those who completed surveys were part of the experimental group (received checklist), while the remaining 53% were part of the control group (did not receive checklist). Nine (50%) of 18 volunteers with a checklist spoke to patient navigation and/or lifestyle educators before presenting to an attending, compared to 1 (5%) of 20 volunteers without checklist (p=0.0025). Of the 18 volunteers who received a checklist, 16 (89%) found the checklist helpful. There was no significant difference between mean visit time pre-checklist (74 minutes, SD= 29.6) and post-checklist (79 minutes; SD=28.3; p=0.46, n=134).
Conclusion: The checklist improved clinic flow by increasing volunteer accuracy and adherence. The checklist was also perceived to be helpful, and did not increase patient visit times.
Copyright (c) 2021 Alyssa Scott, Dolly Patel, Alexa Hughes, Alexis Reedy-Cooper
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