Imagine you are the supervisor of the health information management (HIM) department in a large outpatient clinic. This department manages patient records. Complaints about your department are becoming more frequent and intense than in the past.

Some clinic employees have complained that the HIM department takes too long to retrieve patient records. Others have expressed dismay over the rudeness of HIM staff. You decide to talk to employees throughout the clinic about the problems.

The clinic's receptionists respond to you defensively. They tell you that the HIM staff won't answer the phone and that they want some backup when they are busy with patients. You talk to the HIM staff and they say they are being charged with more responsibilities but have no additional help. They also complain that the receptionists transfer calls that they should be handling.

The clinic's nurses are also upset with the HIM staff; they claim the department does not help them locate patient charts, causing long wait times for patients. The clinic's physicians say they cannot assume additional tasks to alleviate the situation because their days are already chaotic.

Describe what steps you would take to solve this problem. In your response include:

Which specific QI methodology design (PDCA, FOCUS-PDCS, FADE, RI, Lean, Six Sigma, see Spath, chp 5).

Will you need team meetings? if so, who would be invited and why?

What other steps would be taken to resolve the issue?

Your response should also include answers to the following questions:

What improvement tool would you use to identify possible reasons for the the increase in complaints about the HIM department?

What improvement tool would you use to gather data to confirm the reasons for the complaints about the HIM department?

You hypothesize that complaints spike on certain days of the week. What improvement tool would you use to analyze this theory?

The HIM staff tallies information about the causes of complaints. What improvement tool would you use to prioritize the problems?

What improvement tool would you use to define the current process for retrieving patient records?

You believe that cooperation between the clinic receptionists and HIM staff would improve if phone responsibilities were more clearly defined. To whom would you assign the task of defining roles and responsibilities for staff involved in this issue?

After redesigning the process, you need to monitor the effectiveness of your actions. What improvement tool would you use to determine whether the number of complaints has decreased?