Improvement in Total and Face-to-Face Provider Time in a Multidisciplinary Craniofacial Team Clinic: An Interventional Study

Abstract

Objective:

Identify factors contributing to time a family spends in a Multidisciplinary Craniofacial Team Clinic (MDCT) and implement an intervention to reduce this time.

Design:

Interventional: a restructuring of clinics to serve those patients requiring fewer provider encounters separately.

Setting:

An American Cleft Palate-Craniofacial Association-accredited MDCT in an academic children’s hospital.

Patients/Participants:

One hundred sixty-seven patients with craniofacial diagnoses.

Interventions:

Time data were tabulated over ∼2 years. Following 9 months of data collection, patients requiring fewer provider encounters were scheduled to a separate clinic serving children with craniosynostosis, and data were collected in the same fashion for another 14 months.

Main Outcome Measures:

Principal outcome measures included total visit time and proportion of the visit spent without a provider in the room before and after clinic restructuring.

Results:

The average time spent by family in a clinic session was 161.53 minutes, of which 64.3% was spent without a provider in the room. Prior to clinic restructuring, a greater number of provider encounters was inversely associated with percentage of time spent without a provider (P < .001). Upon identifying this predictor, scheduling patients who needed fewer provider encounters to a Craniosynostosis Clinic session resulted in reduction in absolute and percentage of time spent without a provider (P < .001).

Conclusions:

The number of provider encounters is a significant predictor of the proportion of a clinic visit spent without a provider. Clinic restructuring to remove patient visits that comprise fewer provider encounters resulted in a greater percentage of time spent with a provider in an MDCT.