Creating Value in a Morning Clinic

Charlotte Lee, MD

Resident in Internal Medicine

PGY-2

02/05/2020  

The waiting area where I spent time experience a patients'
cycle of care in one of the ambulatory clinics at MGH

Several days after finishing the value-based healthcare delivery course at HBS, I had the chance to complete an exercise for my outpatient clinic rotation called the “patient footsteps” exercise. As a resident with my longitudinal primary care clinic at the MGH Internal Medicine Associates, the exercise was a way for residents to ask to shadow a patient’s clinic experience from the start to finish of their entire clinic experience (from sitting in the waiting area, to getting checked in with the medical assistants, to the actual visit and then the post-visit). Taking the healthcare delivery course at HBS was highly helpful in the way that I approached this exercise because it allowed me to think more critically about the entire cycle of care for an urgent care visit and also ways for process improvement that would create more value for the patient, providers and all staff involved. If I had not taken the course, I would definitely not have focused on these aspects of the experience and therefore I spent a couple of hours just getting a sense of how primary care could be better delivered by just viewing the mechanics of one visit. When I reflected on this experience, I came up with initiatives that the clinic could work on and how digital technology might be applicable to making the visit more efficient and valuable for everyone.

I very much enjoyed the way the healthcare delivery course was structured and learned a significant amount from the discussion of the cases which were similar in themes that were addressed, but varied in terms of the patient populations that each case focused on. I learned how process improvement occurs in the surgical settings where a lot of quality and safety work was initially started and then how value-based healthcare delivery has been very successfully applied to the primary care setting in one of our cases. I felt that the course was very impactful for my training because it helped me realize that my colleagues and I informally discuss a lot about how to improve value for patients and how to better quantify the value in the work that we do, but that there are tangible ways to do this. Furthermore, I have gained both the tools and the motivation to apply this to the internal medicine space and hope to do so in the future. Little did I know that the course would make my morning sitting in the waiting area of my ambulatory clinic so fruitful.