Patient Visit Redesign (PVR) is a team-oriented, data-driven, work-process redesign program aimed at reducing clinic patient cycle times, improving provider productivity, and raising patient and provider satisfaction. Since 2005, the California HealthCare Foundation (CHCF), working with the California Health Care Safety Net Institute (SNI), has funded implementation of PVR in 48 California public hospital clinics.

SNI worked with the clinics to restructure their patient visit process. The goal was to decrease the time it took patients to “cycle” through the clinic — from the moment they walked in the door to the moment they left the office with follow-up information in hand. The redesign fostered prompt, more efficient visits that enabled many more patients to be seen in these clinics, which serve a large portion of California's uninsured population.

This paper is a report about, and evaluation of, the projects. It finds that safety-net clinics were able to improve provider productivity and patient satisfaction by implementing certain process and structural changes, including: confirming patient appointments; organizing medical visits around the patient; working in cross-functional teams; and conducting iterative and frequent data gathering and monitoring. In addition to concrete gains in efficiency and satisfaction, evaluators found the introduction of process improvement extended benefits to other areas — helping to spur a culture of innovation among clinic doctors and staff and a commitment to continuous improvement.

The complete publication is available under Document Downloads.