Sharp Rees-Stealy - San Diego, CA

Success Story Award® Winner: Urgent Care

In January 2005, the Sharp Rees-Stealy Urgent Care Center in San Diego began a journey with the goal of improving the experience for patients, staff, and providers. The Urgent Care leadership team met to discuss this journey and decided to adopt a culture of accountability and candor with no holds barred and no excuses accepted.

The plan consisted of 3 simple initiatives: decreasing registration wait times to less than 15 minutes, decreasing door-to-doctor time to an average of 30 minutes or less, and improving compliance with pain assessment and pain control (with the goal of treating pain within 45 minutes of registration) across all 5 urgent care sites.

Prior to January 2005 the results were discouraging—overall rating of care was in the 14th percentile, at least 15% of patients waited longer than 15 minutes to register, average door-to-doctor time exceeded 90 minutes, compliance with pain assessment was at 30%, compliance with addressing pain in a timely manner was at 24%, and patients’ assessment of how well their pain was controlled was at the 18th percentile.

A review of the registration process resulted in the discovery of discrepancies in procedure among the 5 sites, along with several unnecessary steps. After streamlining and standardizing the process, the majority of patients are now registered in 5 to 10 minutes, which makes the goal of a 30-minute door-to-doctor time more realistic.

Meeting the 30-minute door-to-doctor goal was Sharp’s biggest challenge because it meant making significant changes and overcoming staff and provider resistance. The leadership at Sharp began asking questions about patient flow. Now, 2 years later, Sharp is extremely proud of its results. The average door-to-doctor time for the 4th quarter of 2006 was 34 minutes, with some sites as low as 26 minutes. Compliance with pain assessment is 93%, and 63% of pain is addressed within 45 minutes of registration. Patients’ assessment of how well their pain is controlled has skyrocketed—from the 18th percentile to the 77th percentile for the 4th quarter of 2006. In addition, overall satisfaction score has gone from the 14th percentile to the 79th percentile, with some sites as high as the 90th percentile.

Sharp has seen other interesting changes. Employee satisfaction increased by 14% in the past 2 years and provider satisfaction with nursing management increased 26%. Sharp Healthcare’s market share has gone up by 1.5% in the past 2 years, despite the competitive nature of the southern California marketplace.

Sharp Rees-Stealy Urgent Care has truly become one of the best places to work, to practice medicine, and to receive care. This journey was started with the goal of increasing patient satisfaction by improving the urgent care experience, and through the course of driving a service culture an amazing thing happened—everything changed.

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