TAP Success Story

CMS funded the Transformation Clinical Practice Initiative (TCPI) to assist medical practices in their transition from a volume-based to a value-based payment system of compensation. TCPI was designed as a 48 month program starting in September of 2016 and concluding in September 2019. With only 16 months remaining in the program, a cohort of six practices enrolled to work with VPQHC transformation consultants to accomplish transformation initiatives in a condensed time frame. To accelerate these practices through the 22+ milestones and five phases, the VPQHC Quality Improvement Team devised the Transformation Acceleration Plan, or TAP, designed to accelerate the progress for all six practices through TCPI. An additional practice, already enrolled in TCPI, was added to the TAP program which made it seven in total. In five short months the entire TAP cohort caught up to the other practices in the VPQHC portfolio, positioning them to achieve phase 5 and graduating before the end of the TCPI program in September 2019.

The VPQHC Quality Improvement Team deployed TAP by working with the practice staff to view the practice as a system with numerous process areas and opportunities to identify issues that do not add patient value to the patient pathway. These practice-identified issues were then put through a root cause analysis with the practice staff, and counter measure projects were created and prioritized by amount of impact. A patient time study through the system was conducted at both the beginning and end of TAP to understand the patient pathway through the system and to realize the capacity gained by the implemented counter measures resulting in measurable quality improvements. These measurable quality improvements result in increased staff and patient satisfaction.

TAP successfully accelerated progress on TCPI milestones by utilizing a patient centered value stream approach to train staff, establish barriers to patient flow and identify projects to be implemented which would reduce or eliminate those barriers. Projected significant reductions in patient lead time were accomplished (see Graph 1), leading to release an 8% increased capacity, gained on average, per practice which can now be deployed to reduce burden in the practice (see Graph 2).

Graph 1  There was an aggregate of 52% decrease in patient wait time for the seven TAP practices in the three delay areas.

Graph 1

There was an aggregate of 52% decrease in patient wait time for the seven TAP practices in the three delay areas.

Graph 2  Using the 8% average of capacity gained, an employee working 8 hours per day or 480 minutes per day, times 8% gains 38 minutes per day. Imagine multiplying 38 minutes per day by the number of employees in a healthcare organization, and it becomes a significant increase in practice capacity. For example, it would only take 12.6 employees to generate one full time employee per week.

Graph 2

Using the 8% average of capacity gained, an employee working 8 hours per day or 480 minutes per day, times 8% gains 38 minutes per day. Imagine multiplying 38 minutes per day by the number of employees in a healthcare organization, and it becomes a significant increase in practice capacity. For example, it would only take 12.6 employees to generate one full time employee per week.

The VPQHC Quality Improvement Team is happy to share the successes of these seven practices with our colleagues across the healthcare industry. TAP has been so successful that it has been renamed the Transformation Acceleration Program, and is part of a newly launched healthcare transformation system called Infinitum that addresses operational foundations of practice management. If you would like to know more about TAP or Infinitum, please contact us.