Transforming Outpatient Patient Flow: A COVID-19 Driven Quality Improvement Initiative for an Outpatient Model of Care

OBJECTIVE: The COVID-19 pandemic profoundly disrupted outpatient services with challenges including cancellations and delays in consultations, diagnostics, and surgeries. The Acute Hand Program at Trillium Health Partners examined the pandemic's impact as a catalyst for improving an outpatient model of care. METHODS: In 2020, the Acute Hand Program redesigned its care model. This multiyear, quality improvement plan included seven change initiatives ranging from physical space reconfiguration to workflow, admission and discharge criteria revisions, and leveraging community resources. RESULTS: The change initiatives revealed: (1) standardized appointment blocks increased capacity with 4.3% more treatment visits, (2) leaner admission criteria and scheduling consistently eliminated the waitlist to zero referrals per month, (3) length of stay benchmark compliance increased by 18% within 1 year of introducing the new model of care, (4) QuickDASH functional outcome scores remained high, with 94% of patients meeting the benchmark of no more than mild functional difficulty, and (5) overall patient satisfaction increased by 0.5%, with the most notable increase of 5% to 99% in the domain of quality of care. CONCLUSIONS: Developing an outpatient model of care by optimizing physical resources, streamlining clinical processes, using data-driven decision-making, and leveraging community resources enables effective response to crises and ensures quality care and long-term sustainability.