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Observational study to determine predictors of rheumatology clinic visit provider contact time†
Article first published online: 25 JUN 2010
Copyright © 2010 by the American College of Rheumatology
Arthritis Care & Research
Volume 62, Issue 11, pages 1650–1654, November 2010
How to Cite
Davis, L. A., Larson, M. M. and Caplan, L. (2010), Observational study to determine predictors of rheumatology clinic visit provider contact time. Arthritis Care Res, 62: 1650–1654. doi: 10.1002/acr.20281
- Issue published online: 2 NOV 2010
- Article first published online: 25 JUN 2010
- Manuscript Accepted: 15 JUN 2010
- Manuscript Received: 22 FEB 2010
- NIH (National Institute of Arthritis and Musculoskeletal and Skin Diseases). Grant Number: T32-AR007534-24
- VA Health Services Research and Development Award. Grant Number: CDP 09-388
To address perceived inefficiencies in an academic rheumatology practice, a timing/work-flow evaluation was initiated to determine the factors that predict the provider contact time (PCT), i.e., the amount of time that attending physicians spend with patients during an outpatient encounter.
This prospective observational study was conducted at the University of Colorado Hospital Rheumatology Clinic for return patient visits in early 2008. Each patient encounter was subdivided into components, and the time for each component was recorded. Up to 20 return-visit encounters per provider were randomly selected for inclusion. Multivariate linear regression was used to predict the time, in minutes, that providers spent with patients, and logistic regression was used to determine the time intervals associated with the patient's perception that the visit ran on time.
Variables associated with increased PCT were whether a procedure was performed in the clinic (P = 0.037) and whether the visit occurred in the afternoon (P < 0.025). For every minute a provider was late in beginning to see a patient, the PCT decreased by 0.32 minutes (95% confidence interval [95% CI] 0.15, 0.49). Variables associated with the patient's perception that the visit ran on time included the check-in to vitals delay (odds ratio [OR] 0.95; 95% CI 0.92, 0.99) and the provider delay (OR 0.92; 95% CI 0.86, 0.99).
The patient's punctuality and the presence of a resident are not significantly associated with the time that a provider spends with a patient. However, the degree to which the provider runs late was associated with decreased PCT and diminishes the patient's perception that the visit is running on time.