Virginia Mason Kirkland Clinic

Kirkland, WA

Virginia Mason’s Kirkland Clinic and Versus Advantages brings together LEAN management principles, an innovative clinic design (with no waiting room!) and interval care to provide an improved patient experience.

Installation Highlights

  • Utilizes LEAN Management Principles
    • 80 FTEs
    • 20 Physicians (Full and Part-time)
    • 42 Exam Rooms
  • 400-500 patients per day (all services)
    • Expected 300 to 400 when designing new clinic
  • Sensory Network & Flow Components
    • 144 IR Sensors
    • 7 RF Sensors
    • 45 Remote Stations
    • 12 Badge Drop Boxes
    • 3 Badge Cabinets
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Case Study

How Versus RTLS Improves Patient and Staff Experiences

Clinics throughout Seattle’s Virginia Mason Medical Center are working to improve processes and reduce wait times, so when Virginia Mason Kirkland had a unique opportunity to design new facility space, they jumped at the chance to use innovative approaches to improve patient satisfaction and reduce wait times. The Versus Advantages™ Real-time Locating System was a key tool to help the team tackle a significant patient dissatisfier in healthcare today: waiting for care providers.

Tick Tock: Who Likes to Wait?

In most healthcare clinic settings, patients hurry to arrive on time only to watch the minutes tick by in a waiting room first, then an exam room later. Meanwhile, doctors and staff spend the day continuously behind schedule, trying to catch up and frequently apologizing to patients for delays, which contributes to staff dissatisfaction.

When Virginia Mason Kirkland had the opportunity to move into a new building, teams of providers, patients, architects and design specialists took a close look at the clinic experience with a clear objective: reduce the wait for patients and improve satisfaction for patients and staff. Key to the team’s success was to visually identify where patients waited and use that information to improve work flow processes.


“I just spent less time in the waiting room, and felt I had more time with my doctor and nurse to talk about my concerns.”

Philip Strain, Patient

“Understanding where our patients wait was always critical to creating a seamless, value-added experience, but we didn’t have a good system to track and measure time,” said Diane Owen, director of Virginia Mason Kirkland. “We needed to track the patient’s experience from check-in to departure and every step along the way. We needed to know when delays happened and why so we could make changes.”

Answers to important questions were necessary. How long did a patient wait in the waiting room before being escorted to an exam room? How long did a patient wait for a medical assistant to take vitals, ask about medications and update the electronic medical record? How much longer did the patient wait in an exam room after the medical assistant left and before the doctor arrived? And most importantly, did the doctor have enough time with the patient to answer all of his or her questions and concerns?

“Without a systematic tracking method, we had no way to tell how we were doing or know where we could improve,” said Owen. “We tried a lot of simple methods to track our timing, like stop watches and egg timers. That only gave us a sliver of the picture: one provider’s timing for one portion of his or her day was not enough to base system improvement decisions on.”

Philip’s Experience

Philip Strain has been a patient at Virginia Mason Kirkland since 1991 when he moved from Stanwood, Wash. to Kirkland. A few years ago, Philip was diagnosed with Adult Type 1 diabetes and his visits to Virginia Mason Kirkland became more frequent. So did the amount of time he had to wait. Then Philip began to notice improvements.

“I just spent less time in the waiting room, and felt I had more time with my doctor and nurse to talk about my concerns.” Philip was experiencing small, incremental improvements achieved by the Kirkland clinic through manual timing devices only.

Customer Innovation!
The “run time” that Kirkland Clinic tried so hard to capture using timers and stopwatches is now captured and displayed automatically on the Versus Enterprise View. It’s become a core feature in Versus Advantages Clinic solution.

Customer Innovation!
The “run time” that Kirkland Clinic tried so hard to capture using timers and stopwatches is now captured and displayed automatically on the Versus Enterprise View. It’s become a core feature in Versus Advantages Clinic solution.

More Changes Noticed

After the move to the new clinic facility, Philip noticed even more changes. “My wife and I went to the open house and we learned all about the clinic’s goal to improve the flow of patient care. I was impressed there wasn’t a waiting room and I could walk straight to my exam room after checking in.”

What Philip didn’t know at the time was how the Versus real-time locating system helped the Kirkland clinic staff reduce wait times. Today, Philip arrives at the clinic and upon exiting the elevator, he is welcomed by a receptionist at one of five kiosks. He is given a Versus locator badge and is directed to an exam room. The clinic is circular in design and each hallway has a nature theme, like Mountain or Meadow, with exam rooms numbered. The locator badge, attached to a laminated card marked with Philip’s assigned exam room number directs Philip to the correct location. Philip’s location can be monitored by staff on a color-coded display view, real-time as he enters the clean exam room from the patient hallway, hangs the locator badge on the wall and typically within a minute the medical assistant enters the exam room from the back hallway.

“Some patients may still be surprised by a clinic with no waiting rooms because it’s so different than anything they’ve ever experienced in healthcare,” says Richard M. Furlong, MD, Section Head, Virginia Mason Kirkland Clinic. “Not having a waiting room has some unexpected benefits too, like infection control. No one wants to sit in a waiting room full of people with contagious coughs and colds.”

And while some might expect the patient wait time is merely transferred from a waiting room to an exam room, Owen assures that is not the case. “Our measurements show patients wait on average five seconds before the medical assistant starts the clinical visit. Often he or she is already there when the patient arrives.”

In October 2009, the clinic reported the time from patient “check-in complete” to “exam start” with the medical assistant entering the room was 39 seconds, including walking time from the kiosks down the hallway to the exam room.

Not Just For Wait Times

Virginia Mason Kirkland staff have come to rely on the locator feature of Versus to find key pieces of mobile equipment, like the EKG machine, and often to find one another anywhere in the clinic.

Virginia Mason Kirkland now captures data like this automatically and uses it for process improvement reporting. With Versus, Owen knows how long a patient waits in an exam room before the medical assistant comes in, how long the medical assistant spends rooming the patient, how long the patient waits for the provider, how long the provider is in the room and how long discharge takes. It is detailed data on every patient, every provider…not just a glimpse in time.

“This is something we previously measured with a stopwatch,” said Owen. “We would time those interactions to determine where our improvement opportunities were. With Versus, I’m able to pull the report and quickly see areas for improvement. I have the same data without having to spend hours doing manual timings. And I have it for all my providers, not just one segment of one provider’s day.”

Indirect Care Performed Behind the Scenes

The back door to every exam room opens into the medical zone where physicians and medical assistants work together at flow stations positioned along the building’s perimeter. Here, using the Versus solution, staff can track room status (clean, dirty, patient occupied), patient status (an onscreen figure identifies the location of all people in the building), patient wait times (available on list views), provider status and even mobile equipment location.

This off-stage medical zone is also where teams complete their indirect patient care throughout the day, which is important to reducing wait times for patients. This contributes to patient satisfaction as patients not in the clinic are still given priority for important healthcare needs like receiving their lab results, answering their questions by phone or getting prescription refills processed. In many clinics, this indirect care, which is important work, is batched until the lunch hour or the end of the day. Stacks of paperwork are then processed by doctors making for long work days, and batching delays patients from getting important information and questions addressed in a timely manner.

Impact of Interval Care:
Tackling indirect care between patients saves 100 minutes at the end of the day!

Impact of Interval Care
Tackling indirect care between patients saves 100 minutes at the end of the day!


“Over the last year, we’ve used Versus to run reports to improve our indirect care between patients. What we are looking for is some consistent interval of time, usually 3 to 8 minutes, between patient visits where indirect work can get done in turn,” said Michelle Eakin, supervisor in primary care. “It’s about doing pieces of work, like making one phone call, returning one e-mail and reviewing one lab result. It’s not about having 20 to 40 minutes to power through all of it, but rather tackling small bits of work before seeing the next patient.”

Furlong points out that, at the end of the day, if you’ve averaged 5 minutes of indirect care between patients, you’ve done 100 minutes of work. That’s more than an hour and a half you won’t be spending doing batch paperwork at the end of the day.

Kirkland clinic’s providers also value the Versus list view because it shows how long the medical assistant, nurse or doctor have been in the exam room with the patient. It helps each care provider gauge how much time he or she has before the patient will be ready for the next portion of the care visit. This “production planning” increases productivity time for each provider, reduces the guess work for when the provider will be needed and has made a real difference in staff and patient satisfaction.

Real Results in Reducing Wait

Virginia Mason Kirkland’s patient satisfaction scores are some of the best in the region, and the team attributes this to improvements in flow, the new clinic environment and tools like the Versus real-time tracking solution.

Eakin notes, “Patients are waiting less, so while they spend less time in the clinic, time with the provider is not compromised.”


Locating a Benefit
“Versus enables us to find one another and know where the patient is and how long he or she has been waiting in a variety of views that improve our workflow. Versus provides the visual awareness we needed to create this unique, highly progressive environment.”

Richard M. Furlong, MD, Section Head
Virginia Mason Kirkland Clinic

About Virginia Mason Kirkland Clinic

Virginia Mason Medical Center, founded in 1920, is a non-profit comprehensive regional health-care system that combines a primary and specialty care group practice of more than 480 physicians with a 336-bed acute-care hospital in Seattle. In addition, Virginia Mason has a network of clinics located throughout the Puget Sound area and manages Bailey-Boushay House, a nursing residence and Adult Day Health program for people living with HIV and AIDS. Virginia Mason also has an internationally recognized research center, Benaroya Research Institute at Virginia Mason.