Whether you’re a physician, a tech, or a front-office warrior, your time is a finite resource. And like it or not, the demands on that time are increasing. Compliant documentation, providing first class customer service, and yes, chronically late patients and doctors all slowly chip away at the daily schedule that should be working. So why isn’t it?
A lack of good data and careful analysis is often the problem, Derek Preece of BSM Consulting told attendees at AAO2015. What worked 5 years ago or even last year doesn’t work now. With the constant pressure of decreasing reimbursements, the urge to pack your schedule with patients is understandable. If you consistently find yourself wondering how you got so far behind (when the day has barely even started), it’s time to reassess your approach to patient flow.
Wondering where to start? Below, Preece solves your three biggest patient flow problems:
Problem #1: You don’t know how long different types of exams take.
The most expensive thing in your eye care practice is an empty exam room. This is where many ECPs get tripped up, according to Preece. “It’s hard to get the data. Most practices won’t spend the time or the money,” he says. Accuracy is important, since miscalculations of even a minute or two can add up to big chunks of time over the course of a day.
Solution: Don’t assume your estimates are correct. Use a tracking system to measure times the doctor spends with each patient for different types of exams. This could mean using a low-tech tracking sheet, using your EHR system to track times, or even hiring a temp to record information over a week or so. Then, use the data to determine the percentage of your schedule taken by each type of exam.
Problem #2: You schedule without regard for how long an exam takes.
It’s not uncommon for practices to schedule their days based on a pre-determined template, what they hope to be doing, or feel like they should be doing. This disconnect is why a schedule that looks viable on paper leads to a backed up waiting room in reality. Your schedule should be based on the actual, measured time the doctor needs to see his or her patients.
Solution: Embrace reality. Design a schedule according to the data you’ve collected, not what you think is happening in the office.
Problem #3: You are inconsistent in your approach to patient flow.
Whether you have one person who does all your scheduling or an entire call center on duty, stay consistent. Patients should get the same information no matter what time they call or who they speak to.
Solution: Utilizing a script goes a long way in making sure all the right questions are asked and answered, including identifying the reason for the visit and any special circumstance that could affect the length of the appointment. This is also a great time to make a habit of telling each patient your broken appointment/late patient policy. Make it part of your appointment staff’s script and patient portal instructions. Over time you will reduce the risk of no shows, late cancellations, and excessively late arrivals.
Tip: Verbalize your broken appointment rule as a benefit statement. Instead of simply telling patients that you require 24 hours notice for broken appointments (or they’ll face a fee), say something like: “We understand that patients sometimes have changes in their schedules. In order to avoid a broken appointment fee, we kindly request 24 hours notice so that we can reschedule to accommodate any scheduling changes you may have.”
So what about that fancy scheduling software or practice management system that was supposed to keep you on track? The urge to rely on technology to solve your patient flow problems is hard to resist. But Preece cautions against using technology as a band-aid. We often prescribe solutions without diagnosing the problems, he says. Layering technology over a broken system may work in the short term, but will soon leave you back where you started: frustrated, with a schedule that’s stretched to its limit.
