Retrofitting Clinics for Self-Rooming

• COVID-19
• HIPxChange
• Primary Care Academics Transforming Healthcare (PATH)
• Quality and Safety

Background

Self-rooming is a relatively new process where patients direct themselves to an assigned exam room immediately after checking in, bypassing the traditional waiting room experience where a staff member would escort them from the waiting room to the exam room. Self-rooming decreases waiting time for patients and decreases staff time and cost while increasing patient satisfaction (Kamnetz 2015). However, leaders of traditionally designed clinics have often been reluctant to redesign the rooming experience, thinking that their buildings needed specific features like hallways with few intersections, and dual access rooms (Karp 2019). Previous studies of self-rooming have demonstrated that self-rooming can increase efficiency, cost-effectiveness and patient satisfaction, but emphasize the need for technology (mobile patient communicators (Presutti 2019)) and specially designed buildings.

Health systems responded to the threat of COVID-19 spread by rapidly retrofitting existing clinic layouts to promote physical distancing. Self-rooming was one approach to avoid viral exposure in a waiting room. Our health system successfully piloted self-rooming in two clinics in 2008-09, which informed the design of four clinics in 2015-16 that were specifically designed and built to improve team-based care and patient flow (Kamnetz 2015). Faced with the need to limit COVID-19 spread, our health system quickly overcame concerns about uninviting or confusing building infrastructure, patients getting lost, or unescorted patients compromising privacy. The rooming process was rapidly redesigned to implement self-rooming in the majority of our primary care clinics without the need for investments in technology or building construction.

The Retrofitting Clinics for Self-Rooming toolkit provides a framework for implementing self-rooming in any primary care clinic, including those that were not intentionally designed for this purpose. The tool provides decision-makers with prerequisites to consider, tips, supplies needed, and the steps to implementation, as well as workflows for patient check-in and check-out.

Who should use this toolkit?

This toolkit is intended for healthcare administrators, clinicians, and operational decision-makers.

What does the toolkit contain?

The following materials are included in the toolkit:

• Self-Rooming checklist
• Self-Rooming check-in workflow
• Self-Rooming check-out workflow
• Survey instruments
• Patient self-rooming sheet and map

How should these tools be used?

Development of this toolkit

The Retrofitting Clinics for Self-Rooming toolkit was developed by researchers and clinicians (Principal Investigator: Sandra Kamnetz) at the University of Wisconsin-Madison School of Medicine & Public Health – Department of Family Medicine and Community Health.

Support was provided by the University of Wisconsin School of Medicine and Public Health’s Health Innovation Program (HIP), the Wisconsin Partnership Program, and the Community-Academic Partnerships core of the University of Wisconsin Institute for Clinical and Translational Research (UW ICTR), grant 9 U54 TR000021 from the National Center for Advancing Translational Sciences (previously grant 1 UL1 RR025011 from the National Center for Research Resources). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or other funders.

Please send questions, comments and suggestions to HIPxChange@hip.wisc.edu.

References

1. Ramly E, Kamnetz SA, Perry CE, Micek MA, Arndt BG, Lochner JE, Davis S, Trowbridge ER, Smith MA. Primary Care Patients’ and Staff’s Perceptions of Self-Rooming as Alternative to Waiting Rooms. Ann Fam Med. 2023 Jan-Feb;21(1):46-53.
2. Kamnetz S, Marquez B, Aeschlimann R, Pandhi N. Are waiting rooms Passé? A pilot study of patient self-rooming. J Ambul Care Manage. 2015 Jan-Mar;38(1):25-8.
3. Karp Z, Kamnetz S, Wietfeldt N, Sinsky C, Molfenter T, Pandhi N. Influence of Environmental Design on Team Interactions Across Three Family Medicine Clinics: Perceptions of Communication, Efficiency, and Privacy. HERD. 2019 Oct;12(4):159-173.
4. Presutti RJ, Willis FB, Scott R, Greig HE, Abu Dabrh AM. “No Waiting” in the “Waiting Room”: The Self-rooming Patient Pilot Study. Cureus. 2019 Nov 26;11(11):e6238.

Toolkit Citation

Kamnetz, S. Retrofitting Clinics for Self-Rooming. University of Wisconsin-Madison. Madison, WI; 2022. Available at: http://www.hipxchange.org/SelfRooming