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Do You Have an Efficient Appointment Scheduling System?
Physician Schedules – The Key to Patient Access
Patient access can become a point of frustration for everyone. As physicians try to fit patients into their schedules, staff tries to schedule patients, and patients try to obtain timely appointments with their physicians, they all wonder is there a better way. Physician schedules are your key to patient access.
Patient access depends on an efficient appointment scheduling system. You must ask yourselves many questions to determine if you have an efficient appointment scheduling system. Do the ancillary services support efficient patient flow? Do you have appointment scheduling policies and procedures in place to support operational efficiency? Do you have initial and continuing training and support for the appointment scheduling staff? Are you utilizing appointment letters and appointment reminder calls? And most importantly, are your physician schedules set up to diminish overbooking and minimize patient wait times?
Schedule Analysis
When reviewing physician schedules for efficiency it is important to look at several key indicators: next available appointment, patient wait time, overbooking and patient satisfaction surveys. Results of patient satisfaction surveys will generally be the first indication that you have an immediate problem. Patients who are not happy tend to complain or leave the organization. Stressed appointment staff become frustrated when they are unable to give patients an appointment in the near future. Frazzled clinical staff become embarrassed by patients continually asking, “how much longer before I am seen by the physician?” Physicians become stressed by overbooking when they see the stacks of patient charts indicating how far behind they are running. In addition, no show and cancellation rates can indicate that patients are unhappy with wait times. Referring physicians may show their dissatisfaction with the next available appointment by discontinuing to send their patients to your organization.
To improve the set up of physician schedules, the following variables should be determined:
- Are all slots utilized?
- Is the time allocated for each appointment type truly the actual time needed for the appointment type?
- Are ancillaries dependent for the specific appointment type?
When a schedule is set up with specific appointment types at designated times, a mechanism should be in place to ensure that all slots are filled and do not remain empty because a request was not received for a rarely used appointment type. Some computerized appointment scheduling systems allow you to set up switches if appointment slots are not utilized at specific intervals. Switches allow you to change the appointment type originally designated for a slot when it is not booked by a designated date.
The amount of time physicians need for a particular appointment type can be determined by performing clinical time studies. Time studies can also assist with formulating schedules when appointments are dependent on ancillary services. Often times when an ancillary service is required, the physician schedules can be defined to allow for the patients requiring a diagnostic test to fit back into the clinic schedule. This can prevent a severe backlog at the end of the day.
Ancillary departments within the organization can significantly impact patient flow. When physicians require diagnostic tests as part of their patient’s visit, it is critical to ensure that these appointments are coordinated with the ancillary department. Appointment scheduling can assist the ancillary departments with staffing their departments to support physician office hours.
Restructuring Physician Schedules
If it is determined that physician schedules need restructuring, it is best to obtain the support of an executive sponsor. The executive sponsor will understand what it takes to make the change succeed and will champion the project. Collection of data in easy to understand charts will enable you to identify the root causes of physician schedule issues. These charts can be utilized to convince physicians that schedule changes are necessary to achieve patient, staff and physician satisfaction. In addition, it is critical to have key indictors established in report cards to guarantee the ability to monitor and measure progress. Placing these report cards on a Website with password access for each individual physician will allow physicians to monitor their metrics. The analysis of physician schedules should be conducted on an on-going basis by a manager with analytical abilities. Tools such as report cards can be developed to assist the staff responsible for maintaining and monitoring the physician schedules. Utilizing report cards as a measurement tool enables monitoring of the third next available appointment, slot utilization and patient clinical cycle times in order to make the appropriate adjustments to physician schedules.
Components of Restructuring
Several components must be included to ensure that the restructuring of physician schedules is a success. Staff must be provided the tools to understand how they are expected to perform their daily responsibilities. Staff is expected to schedule appointments in an efficient and professional manner. Each employee should be given adequate training and a written policy and procedure manual. It is management’s responsibility to ensure that each staff member attends training and follows the organization’s policies and policies.
Policies and Procedures
Critical steps to ensure that the appointment scheduling staff is following standard operating procedures consistently includes the development of and adherence to standard policies and procedures. Operational policies and procedures should be implemented and reviewed regularly by staff and management to ensure realism in their support of the mission of the organization. These policies and procedures should include appointment scheduling rules and requests from each individual physician. These rules and requests should support the mission and values of the organization. Additionally, policies and procedures should include customer service and scheduling requirements for each specialty, as well as data collection requirements for each appointment. Tools should be developed to ensure Quality Assurance and to monitor and measure compliance. It is also important to establish a communication protocol to ensure that all scheduling announcements and updates are delivered real time. E-mail is an excellent way to deliver these updates.
Training and Support
The success of the appointment scheduling staff is directly dependent on training and support. A mandatory training program should focus on system education, i.e., entering demographic and insurance data accurately, and selecting a proper appointment at a suitable time for the physician and the patient, with a strong emphasis on customer service. A support line should be established to assist the appointment scheduling staff with questions that arise during business hours. At regular intervals appointment scheduling staff should be monitored and measured to assess needs for additional training.
Additional Appointment Scheduling Features
Many computerized appointment scheduling systems have the ability to create appointment confirmation reminders and interface with appointment call reminder systems. This will enable you to make certain that you are doing everything to ensure that your patients will present for their appointment on the correct day, at the correct time and at the correct location.
By ensuring that your physician schedules, which are the key to patient access, are designed efficiently, you will enhance the ability of your patients to make an appointment with their physician in a reasonable amount of time, staff will feel less stressed, and physicians will no longer have schedules that overwhelm them. Continuing to measure and monitor physician schedules, utilizing tools such as report cards, will make certain that your physicians’ schedules continue to operate with peak efficiency and provide patients with access to your organization in a timely manner.
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About the Author
Cynthia Ethier has more than 22 years of business experience in the health care industry. Ms. Ethier’s experience includes physician system implementations, re-engineering of practice operations, and the management of Information Services resources. She is well versed in the management, implementation, and training of front-desk applications. In a recent consulting engagement, Ms. Ethier provided interim management and analytical analyses of the Registration, Charge Entry and Payment Posting applications for an academic multi-specialty physician group practice. She successfully decreased staff overtime by 100% while increasing productivity by 50%. Ms. Ethier can be reached at 781-982-8400 ext. 417 or cethier@beaconpartners.com.
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