You are the new administrative resident for a family practice clinic. On the first day of your new job, the clinic director gives you the following chart showing a snapshot of patient encounters over the course of a day in the facility.
There are currently 8 providers in the clinic. Providers 1 and 2 are Physician Assistants, Providers 3, 4, 5 and 6 are Nurse Practitioners and Providers 7 and 8 are Physicians. The clinic director tells you that although this statistical process control graph only represents activities for one, an 8 hour day, the outcomes are very consistent for each provider over the course of a week and for a month.
The director also tells you that although Provider 4 is seeing more patients per day than his peers, that this provider is also receiving low to average feedback from patients because they feel the provider is rushing them through their appointment. The opposite is true for Provider 3 where this provider always receives the highest patient satisfaction scores on a quarterly basis from patients.
Provider 8 is the clinic’s Fellow in Family Medicine, and reviews all the cases of the other providers on a regular basis. Provider 7 is an intern and just out of medical school the previous year.
Providers 1, 2, 5 and 6 have all been with the clinic since it opened 5 years ago . All four providers receive equal patient satisfaction feedback on a quarterly basis from patient encounters and both the PAs and the NPs have equal loads of administrative duties.
Exercise:
Using the terms discussed in this chapter (Effectiveness, Efficiency, Benchmarking, Optimization, Performance, Efficacy and Quality), assign each provider a designation based on his or her outcomes. Note that not all the terms need to be utilized, and some of the terms can be used more than once.
After you have assigned each provider a term from the chapter, answer the following questions:
Why did you assign that term to that particular provider? Why is this term a better reflection of outcomes than another term?
Is there any one group of providers (Physicians, NPs or PAs) that are more reflective of one term than another? Why?
Do you feel that these outcomes are the result of natural variance in the clinic or are other influences at work? Why?
Based on your knowledge of the terminology presented in this unit, if the clinic leader asks for your opinion to improve Effectiveness, Efficiency, Benchmarking, Optimization, Performance, Efficacy and Quality in the clinic, what might your plan of action be for each? Why?
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