What is Cycle Time?
The cycle time is the amount of time it takes a patient to move from one point to the next in the context of the patient visit. The clock begins at check-in and stops when the patient checks-out.
Why Conduct a Cycle Time Study?
Cycle time tells you how patients move through your practice in the context of the visit. It measures time spent at each touch point.
- Identify bottlenecks or time delays in the patient visit
- Identify inefficient workflow or layout
- Identify possible insufficient staffing or scheduling
- Overall, improve the patient experience and staff satisfaction
However, before investing the time and resources in conducting a cycle time study, understand why you want to look at cycle time and what you’ll do with the results.
Conducting the Study
Conducted by the Quality Improvement Coach or Practice Staff Member
Before you get started, communicate to the team, including the physicians, you are tracking the time the patient spends in the total visit, what the process will look like, and how the information will be used. Be sure they understand this is a continuous improvement activity, not an opportunity to point fingers or assign blame.
- Talk with the staff to make sure understand the workflow – registration, rooming process/flags/lights/boards, and check-out.
- Select a day or days that represent a typical day in the practice and all providers are seeing patients.
- Locate an observation post or posts that will allow you to track the time without interfering with the workflow or altering the existing process.
- Note the cycle time process will likely be a full day job if only one person is tracking patients.
- Using the Cycle Time Tracker worksheet, the QI Coach documents the time at each transition or touch point with a member of the practice with the description of the touch point. E.g. Check-in, rooming/vitals, physician visit, lab/x-ray, nurse/medical assistant, check-out, etc.
- The Cycle Time Tracker is also available in Excel. The QI Coach can use this version to enter the times directly into the spreadsheet and generate a report for interpreting the data.
- Collect data on a sampling of patients across all providers throughout the day. E.g. 15 patients in a day.
- If the physician/nurse/medical assistant leave the exam room and return, track the time in the exam room separately.
- Round each time period up to the next minute.
- If tracking manually via paper worksheet and a clipboard, enter the data from each patient into the Excel worksheet to generate a report for review. Complete this step at the end of the day of tracking if at all possible while the patients are still fresh in your memory.
Conducted by the Patient
While this method would free up the Coach or Staff member, the risk of inaccurate tracking increase significantly. You must also consider what this request communicates to your patient – will patients see being part of the process as positive or negative? This will depend on the patients you engage but be careful not so skew the results through patient selection.
- Distribute a hard copy tracking sheet with instructions for when to document the time stamp and the format needed.
- Walk the patient through the process and encourage them to note any additional observations they have, e.g. materials not available in the exam room.
- Be sure to provide instructions as included as if a QI Coach or Staff member were tracking
- Verify the patient has a reliable method for tracking the time, e.g. watch, cell phone.
- Designate a drop off point for the tracking sheet, e.g. hand off to check-out, place in a folder/envelope, etc.
As a thank you, consider some small token of appreciation for those who help collect the data.