Connections February 2024 - 8

Team approach
How Dermatology reduced patient backlog
Shane Chapman, MD, MBA, chair of
DHMC's Dermatology Department,
knew the new patient backlog in his department
was becoming overwhelming,
and they needed to find a solution.
" One year ago, our referral list was
growing to 100 patients per day and
at its peak we had 3,700 people in our
referral queue waiting for an appointment.
We were fully booked for 6-9 months in
advance, " he says. " There was nowhere to
schedule all of these patients. "
To address the situation, they decided
on a new approach that would engage
every member in the team in a 5-day " big
access week " to reduce the waiting list
and get patients into appointments. They
blocked out a week in December 2023 to
schedule 15-18 patients every 20 minutes,
with the goal of seeing up to 400 patients a
day, Monday through Friday. They created
3 pods made up of 3 residents each with
one faculty member, and 3 additional
pods of dermatology nurses and faculty.
Patients were scheduled onto a single
resource schedule and assigned to one
of the resident or nursing teams when
they checked in. Although these were
abbreviated new patient visits, patients were
able to schedule follow up appointments as
needed at exit from the clinic.
The dermatology team found that for the
most part, patients understood that they
were offered a brief appointment so they
could be seen. They said that patients were
so grateful to be scheduled, the response
was overwhelmingly positive.
" We felt empowered. The patients were
very happy and there were lots of positive
comments, " said administrative supervisor
Jean Henry.
The approach also created a sense of
teamwork throughout the department.
Chapman says the staff were physically
tired but mentally excited and energized.
Residents and nurses also had
opportunities to learn and see things they
may not have before. The week resulted
in a total of 1,588 patients being seen with
over 250 different diagnoses and the
discovery of 9 melanoma (tumors).
" It was all hands on deck and it became
a cultural thing, building rapport within the
staff. They were all expected to be there, and
they were all in. Everyone contributed, and
they were so enthusiastic-it is joyful when
that kind of thing happens, " Chapman says.
Chelsea Worthen, MBA, PMP, director
of operations for primary care and
dermatology agreed. " I really enjoyed it.
I cleared my calendar for that week and
immersed myself with the team. We were
all enjoying ourselves. Being able to help
patients and get out of my comfort zone
Dermatology
Department reduced its
patient backlog significantly
after an intense week of
was really fun, " she says.
" We learned that there's a place for
everybody. We were all
willing to think differently
to both take care of
patients and help people
find meaning in their
work, " says Caitlin Yazel,
APRN, dermatology nurse
manager. " The lessons
we learned about culture,
about pulling a team
together were some of the
most important parts of it. "
They are already
planning replicate the
access week again. " We
want to incorporate this
into our fiscal year as
a way to create so
much more space
for patients, "
The DHMC
scheduling hundreds of patients
a day. Department chair Shane
Chapman, MD, took this
photo of staff at 5 pm, still
energized and working
as a team.
Chapman says.
" Going forward,
it's not just a
unique thing but
something we will
make part of our
regular work. "
Connections February 2024

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