As I'm sure you may have unfortunately experienced, patients waiting and complaining to the front desk, physicians feeling behind and rushed all contribute to a highly stressful environment … as if healthcare today weren't stressful enough.
Aside from reducing stress for all concerned parties, improved patient flow contributes to an improved bottom line—better patient flow, more patients equals improved bottom line. A more profitable practice also reduces stress for everyone.
Ultimately, improved patient flow sends a message to all of your key stakeholders—the physicians, the staff and the patients—that your practice values and respects people and their time, and that you have a serious commitment to a well-run healthcare and business organization.
Look at schedules. Review templates. Check capacity and fill rates. Seek to understand the physician's practice style. Monitor a patient's progress through the practice and time-stamp each different phase of the patient visit. Research to understand. Identify each of the points in the patient visit that have implications for patient flow.
In her every-practice-administrator-must-have book, Mastering Patient Flow, Elizabeth Woodcock addresses critical areas including telephones, scheduling, prescriptions, checkout and technology in an effort to improve patient flow through the office. She covers the entire patient-flow process from the first phone call on.
Each of the practices I've been working with recently has had some sort of patient-flow issue. Here are some of the things that I've seen work in these practices. It's important that you make these your own. Your practice layout may be different or the physicians may have a different practice style. Staffing ratios may be different as well as patient expectations.
In a very busy ear, nose and throat practice, the physician recently added a scribe for his patient-visit notes. Now he is able to establish excellent rapport with the patient, document the visit and move to the next patient, all very efficiently. The scribe allows him to see more patients, improve patient access and flow, and more than covers the scribe's fees.
Phones can be our friend or our enemy. The practice administrator at a busy primary-care office (27 providers) decided to take advantage of phone training from the local call center of a nationally known company. The result: improved patient satisfaction with the phone staff, improved employee satisfaction, and improved throughput and processing of phone calls with far fewer complaints about being put on hold endlessly. There are specific techniques that enable these call centers to provide superior phone service and bringing these skills to this office made a huge difference.
“The doctor didn't give me my refill this morning.” “I called this morning and the nurse never called me back.” Every time one of your staff has to address the phone, valuable time is lost from on-site patient care. Once the practice scripted the nurses to inquire about refills when rooming the patient, and noting the need on the chart, coupled with the checkout staff being scripted to inquire as to whether the patient had all refills needed, the volume of calls declined. Add to that a clarified message on the phone voicemail clearly stating when the call would be returned, rather than as soon as possible, and call volume goes down. With call volume down, staff resources can be applied elsewhere to assist in improving patient access and flow.
Your office does not have to be the one people talk about—at least not in a bad way. You can improve patient flow and access. Research, observe, learn, document and understand. Then, and only then, should you tackle the process of improving patient flow. Be sure to monitor your progress and modify your plans as necessary.
PrincipalMGMA Health Care Consulting GroupEnglewood, Colo.
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