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Abstract

NYC Health + Hospitals / Gouverneur serves more patients than any other diagnostic and treatment center in New York State. As part of the NYC Health + Hospitals public health care system, which serves 1.4 million patients and is the largest municipal health care delivery system in the United States, Gouverneur strives to serve the needs of both scheduled and unscheduled patients. Within Gouverneur, the Women’s Health department treats approximately 1,600 patients per month through approximately 2,100 visits. In September 2014, Gouverneur’s Women’s Health department launched a weeklong process improvement initiative known as a Rapid Improvement Event (RIE). Structured through Breakthrough, the RIE focused on improving the process of serving urgent needs patients, including those that arrive without an appointment or miss their appointment time, or those who call with an urgent issue. As the team examined problems faced by urgent needs patients – including the amount of time required to complete a visit, and barriers to having an appointment scheduled the same day with a provider – they discovered that the root of many issues was simply variability in how staff members approached the unexpected patient. To solve the issues in a low-cost, sustainable way, the team set to work designing staff trainings to enhance staff skills and improve the experiences of urgent and unscheduled patients. As a result, staff members were better able to support the needs of patients with urgent needs, ultimately improving the patient experience.

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