A commitment to quality improves service at the Mackenzie & District Hospital

Sharon KennedyWhen Sharon Kennedy accepted the position of Primary Health Care Coordinator for the Mackenzie & District Hospital and Health Centre, it came with some exciting learning opportunities. Although she had been with the hospital for 26 years, the concept of quality improvement was new to her. That’s why she jumped at the chance to participate in ImpactBC’s, Art and Science of Innovation and Improvement program, and work on an improvement project in real-time while connecting it directly to coursework.

The Health Centre is an integrated facility housing physician, public health, addiction and lab services. Located in a remote community two hours north of Prince George, the facility has had difficulties hiring full-time physicians. They presently have one nurse practitioner and three full time doctors that see approximately 30 patients a day.

“We were finding that patients were used to not having a physician,” she explains, “They would call to make an appointment, find out they couldn’t get in for three weeks, then use a walk-in clinic in Prince George or the emergency department instead. When it came time for their appointment, they wouldn’t show up, leaving a vacancy.”

Sharon is using the course to help the community understand that the clinic is fully functional, has available appointments, and patients are expected to show up for scheduled appointments. “If clients understand how the system works and that it’s a partnership, they will respect it more and try to work with the clinic instead of against it.”

Working from a six month plan, Sharon hopes to reduce the number of missed appointments from 17/week to 1.5/wk.

“I’ve developed a navigation tool so instead of just getting an appointment card, a client now receives information about the changes that have happened in the clinic and how to  prepare for their visit to make it more efficient,” says Sharon. “We started in September. I’ve been monitoring the number of no-shows in the clinic as well as the use of the emergency department here in McKenzie hospital for non-urgent visits.”

Another objective of the tool is to encourage patients to check in with the reception desk before leaving the clinic.

“We found that sometimes it’s so busy at reception that people don’t want to stand and wait – they’ll just leave,” she explains. “Appointments aren’t rebooked or rescheduled or patients arrive at the lab and their requisitions aren’t completed. We wanted to improve flow for everybody and help patients understand why we want them to stop and take a few more minutes.”

Sharon has been surveying clinic users as part of the process to see how they feel the clinic is running and what improvements can be made.

“The general response is they feel the clinic runs well. Their chief concern has been instability of physicians which results in the lack of the continuity of care. They don’t understand their medications and they’re tired of telling their story over and over again. Since they were always seeing somebody new they felt that person didn’t really care about them—those are their exact words.”

Sharon admits that the time commitment of the course has been a challenge as her position is part-time. “The course is as valuable as it is enormous. Now that I’m doing the surveys and seeing the results I’m feeling good about it. I see people really supporting the clinic through their responses.”