This is a summary of my internship at Peppertree Family Medicine Center at Arrowhead Hospital.

1. Internship Experience
Summary
Requested from: St. Joseph’s Hospital Family Residency Program –
MHSM Internship
Presented by: Mariana Sabeva

2. Agenda
1. Why my Internship Project is Important to St. Joseph
2. Expected Benefits
3. Project Objectives
4. Design a Survey
5. Survey Administration
6. Survey Results (preliminary)
7. Next Steps
8. Q & A

3. Internship Project Importance
Phase Phase Phase Phase Phase Phase Phase
I II III IV V VI VII
1. Peppertree Family Medicine’s ultimate goal – NCQA certified
2. My internship project – part of a multiphase project
3. Current problem – inability of patients to be seen in a timely
manner
4. Project goal – identify what causes the problem and make
suggestions for improvement

4. Expected Benefits
1. Increase of unduplicated patients
2. Increase of visits
3. Increase of new patients
4. Show-rate increase
5. Decrease of wait time for routine visits
6. Patient satisfaction
7. Staff satisfaction
8. Provider continuity rate
9. Decrease of backlogs

5. Internship Project Objectives
DEFINE ANALYZE SUMMARIZE RECOMMEND
Phase I: Phase II: Phase III: Phase IV:
 Identify  Review current  Summarize  Analyze results
problem scheduling research on  Prepare
 Meet with process best practices recommendation
Site  Design a survey  Summarize based on
supervisor  Conduct a survey results previous phase
 Create a survey  Prepare survey summaries
project plan sample report  Present findings
and
recommendation
to Family
Medicine
Program faculty
board

6. How to Reach the Goal
1. Create a project plan with my Site Supervisor.
2. Summarize research on best practices in patient
scheduling in family medicine offices.
 On a national level – literature research
 On a local level – other Residency programs in Phoenix
3. Design and conduct an assessment (survey).
4. Recommend best scheduling process based on:
 Best practices on national and local levels
 Assessment (survey) results

7. Design a Survey
1. Survey goal – phone scheduling system satisfaction
2. Resources used to build the survey questions and format:
 Health Resources and Services Administration (HRSA), US
Department of Health and Human Services
 HCAHPS (Hospital Consumer Assessment of Healthcare Providers
and Systems), Medicare - Hospital Quality Initiative
3. When a survey is an assessment and you don’t need IRB
(Internal Review Board) approval?
 Hospital has a contractual agreement with a survey vendor (St.
Joseph has an agreement with Avatar)
 Survey is not part of “research”, nor is the whole quality
improvement project

8. Design a Survey Cont’d
1. Sample size estimation* – needed elements:
 Target population patients per month
 Anticipated response rate (to adjust the sample)
 Confidence interval – 95%
 Standard deviation and margin of error (ME) – estimated*
2. Attributes:
 Five-point Likert rating scale ranging from “Strongly Disagree” to
“Strongly Agree”
 Uniform rating scale used across all questions
 Inclusion of two open ended questions
 Anonymous and voluntary
 Time duration – between three and five minutes
 Each question refers to one issue
* - Bartlett II, J., Kotrik, J., Higgins, C., Organizational Research: Determining
Appropriate Sample Size in Survey Research, Information Technology, Learning, and Performance Journal, Vol. 19, No. 1, Spring 2001

9. Design a Survey Cont’d
1. Our Phone System:
• Was it easy to reach live operator on the phone
• Did you wait a long time to reach live operator
• Were the phone menu instructions easy to understand?
• Was it clear when to choose scheduler or triage nurse
2. Telephone Personnel
• Was the live operator friendly and helpful
• Did the live operator treat you with courtesy and in professional
manner
• Did the live operator show concern and sensitivity to your needs
• Did the live operator answer all of your questions

10. Survey Administration
1. Distribution Method:
 Hand out printed assessment in the waiting room after visit
 Have available Spanish translated assessments if language
preference is Spanish
 Hand out assessment to every other patient to introduce variability
 Keep track of non-respondents
2. Schedule:

11. Assessment Results*
Section 1 – Our Phone System
Was it easy to reach live Did you wait a long time to Were the phone menu Was it clear when to choose
operator on the phone reach live operator instructions easy to scheduler or triage nurse
33% understand 34%
33%
21%
16% 16% 15%
9% 11% 12%
9% 8%
3% 4% 6% 3% 4% 6% 5%
1% 0% 1% 1% 0%
SD D NAND A SA NR SD D NAND A SA NR SD D NAND A SA NR SD D NAND A SA NR
Section 2 – Telephone Personnel
Was the live operator Did the live operator treat Did the live operator show Did the live operator answer
friendly and helpful you with courtesy and in concern and sensitivity to all of your questions
professional manner your needs 34%
31% 28%
31% 30% 30% 23%
24%
3% 6% 3% 4%
1% 0% 3% 1% 0% 1% 1% 0% 0% 0% 0% 0%
SD D NAND A SA NR SD D NAND A SA NR SD D NAND A SA NR SD D NAND A SA NR
Likert Scale (Commonly Used Psychometric Scale in Questionnaires)
Acronym SD D NAND A SA NR
Description Strongly Agree Disagree Neither Agree Nor Disagree Agree Strongly Agree Not Reported
* Footnote: Preliminary results are based on 63% of administered assessments.

12. Assessment Results * Cont’d
Section 3 – Ease of Getting an Appointment
Was it easy to get an An appointment was An appointment with
appointment available when needed desired doctor was available
when needed
29%
21% 25%
19% 25%
19%
6% 6% 8% 9% 8% 9%
2% 0% 3% 1% 3% 1%
SD D NAND A SA NR SD D NAND A SA NR SD D NAND A SA NR
Section 4 – Required Information
Did the live operator verify Did the live operator get Did you feel that your
that your insurance is your address information privacy was protected
accepted from our office 34% 32%
28% 23%
18% 14%
14% 9% 7%
4% 1% 4% 1% 1%
1% 0% 0% 0%
SD D NAND A SA NR SD D NAND A SA NR SD D NAND A SA NR
Likert Scale (Commonly Used Psychometric Scale in Questionnaires)
Acronym SD D NAND A SA NR
Description Strongly Agree Disagree Neither Agree Nor Disagree Agree Strongly Agree Not Reported
* Footnote: Preliminary results are based on 63% of administered assessments.

13. Patient Age/Sex Histogram*
Age Male Female Total
Patient Population Age/Sex Histogram 19-29 1 11 12
30-39 5 7 12
70-79 40-49 8 13 21
50-59 10 12 22
60-69
60-69 1 17 18
50-59 70-79 0 3 3
unknown 1 0 1
40-49
All 26 63 89
30-39
19-29
15 10 5 0 5 10 15 20
Male Female
* Footnote: Preliminary results are based on 63% of administered assessments.

14. Sex, Language, New Patient
Sex Distribution Patient Distribution Language Distribution
Unknown, Unknown, Spanish,
0.0% 0% 3% Unknown,
New, 11% 0%
Male, 18.6%
Female ,
45.0% Established, English,
53% 61%
English Spanish Unknown
Male Female Unknown New Established Unknown English Spanish Unknown
18.6% 45.0% 0.0% 11% 53% 0% 61% 3% 0%
* Footnote: Preliminary results are based on 63% of administered assessments.

15. Next Steps
1. Finish the assessment administration
2. Summarize assessment results in a report
3. Make a recommendation based on:
 Best practices on national and local level
 Assessment (survey) results
4. Summarize my internship experience in a report

16. Q&A