[Skip to Content]
[Skip to Content Landing]

Pre-Visit Planning Case Report: Prairie Lake Family Medicine

Michelle Ellis, MD, and her team at Prairie Lake Family Medicine in Lincoln, NE, focuses on pre-visit planning as a strategy to improve efficiency and patient care.

The trigger for this approach was the implementation of a system-wide, patient-centered medical home transformation that began two years prior. This organizational change required more preparation before each visit and advance planning of preventive care needs, which contributed to more work for the clinical team.

The team preps for scheduled visits one day in advance; patients who have scheduled an appointment for the same day are prepped prior to Dr. Ellis entering the exam room. The two nurses who support Dr. Ellis are the primary team members responsible for prepping the charts and each have specific responsibilities. One nurse prepares for mammograms, DEXA, and colonoscopies while the other nurse preps for needed vaccines, pulmonary function testing, preoperative EKGs, follow-up imaging, and Pap smears. All clinical updates are documented on the care team's huddle prep sheet and reported to Dr. Ellis. This “divide and conquer” approach ensures that Dr. Ellis's thoughts and priorities for each visit are organized and she is able to get the most out of each patient encounter as efficiently as possible.

Pre-visit planning can also have its challenges. Finding the right ratio of staff to patients to accommodate this new workflow has been an ongoing process. Dr. Ellis works with two nurses and shares a scheduler, a front office staff member, and a lab technician with her office partner. In addition, she shares two part-time team members with other offices and administration, one who helps with referral coordination and one who provides health coaching. Each team member is cross-trained and can cover for each other and perform additional duties as required. Strong team communication is also essential.

To create the best patient experience possible, Dr. Ellis, her partner, and their teams frequently evaluate and make small changes to any new process or procedure they are trying out. They learn what's working and what can be done more efficiently through open dialogue in team meetings. They plan to use patient satisfaction surveys to measure the impact of their new workflows and continue augmenting the processes until they are fully optimized.

As a result of pre-visit planning, the practice is able to provide more preventive services, such as pap smears, mammograms, immunizations, colonoscopies, and bone density scans while improving outcomes for patients.

AMA Steps Forward logo

AMA STEPS Forward® presents actionable, practical toolkits and customizable resources that you can use to successfully implement meaningful and transformative change in your practice or organization. See How it Works

Disclaimer: AMA STEPS Forward® content is provided for informational purposes only, is believed to be current and accurate at the time of posting, and is not intended as, and should not be construed to be, legal, financial, medical, or consulting advice. Physicians and other users should seek competent legal, financial, medical, and consulting advice. AMA STEPS Forward® content provides information on commercial products, processes, and services for informational purposes only. The AMA does not endorse or recommend any commercial products, processes, or services and mention of the same in AMA STEPS Forward® content is not an endorsement or recommendation. The AMA hereby disclaims all express and implied warranties of any kind related to any third-party content or offering. The AMA expressly disclaims all liability for damages of any kind arising out of use, reference to, or reliance on AMA STEPS Forward® content.


Name Your Search

Save Search

Lookup An Activity


My Saved Searches

You currently have no searches saved.


My Saved Courses

You currently have no courses saved.