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BMJ Qual Saf. 2012 Jan;21(1):47-53. doi: 10.1136/bmjqs-2011-000067. Epub 2011 Sep 6.

Development of a primary care physician task list to evaluate clinic visit workflow.

Author information

1
Division of General Internal Medicine, UW School of Medicine and Public Health, 310 North Midvale Blvd., Madison, WI 53705, USA. tbw@medicine.wisc.edu

Abstract

BACKGROUND:

Interventions designed to improve the delivery of primary care, including Patient-Centered Medical Homes and electronic health records, require an understanding of clinical workflow to be successfully implemented. However, there is a lack of tools to describe and study primary care physician workflow. We developed a comprehensive list of primary care physician tasks that occur during a face-to-face patient visit.

METHODS:

A validated list of tasks performed by primary care physicians during patient clinic visits was developed from a secondary data analysis of observation data from two studies evaluating primary care workflow. Thirty primary care physicians participated from a convenience sample of 17 internal medicine and family medicine clinics in Wisconsin and Iowa across rural and urban settings and community and academic settings.

RESULTS:

The final task list has 12 major tasks, 189 subtasks, and 191 total tasks. The major tasks are: Enter Room, Gather Information from Patient, Review Patient Information, Document Patient Information, Perform, Recommend / Discuss Treatment Options, Look Up, Order, Communicate, Print / Give Patient (advice, instructions), Appointment Wrap-up, and Leave Room. Additional subcodes note use of paper or EHR and the presence of a caregiver or medical student.

CONCLUSIONS:

The task list presented here is a tool that will help clinics study their workflows so they can plan for changes that will take place because of EHR implementation and/or transformation to a patient centered medical home.

PMID:
21896667
PMCID:
PMC3568931
DOI:
10.1136/bmjqs-2011-000067
[Indexed for MEDLINE]
Free PMC Article

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