Ophthalmology and Optometry Coding Alert

Hint: It could come down to scheduling and staffing.

When it comes to improving clinical flow at your eye care practice, sometimes it's the little things that make the biggest difference. If you ignore the small nuances of scheduling and staffing, you could be putting your clinical flow at risk and causing the physicians to run behind at the end of the day, said Jane T. Shuman, COE, COT, MSM, OCS, during the Nov. 2017 American Academy of Ophthalmology presentation "Overcoming the Challenges of Clinical Flow."

Which Scheduling Type Do You See?

When it comes to scheduling, three types of scheduling are common in eye care offices:

• Balanced: The same number of patients are scheduled per doctor each hour, and the appointment times are mixed so the doctors always have someone else to see
• Wave: The same number of patients arrive either ever 15 to 30 minutes, based on the premise that they arrive at different times. Any type of appointment can occur at any time.
• Clinic: The session is devoted to one type of appointment, such as cataract evaluations, injections, procedures, or post-op visits. Everyone has a specific protocol to follow.

To determine which of these – or which combination, if applicable – works best for your practice, consider evaluating a few scheduling factors. For instance, when multiple doctors in the practice have a good day in termsof patient flow, compare their schedules in light ofone another.

If patients for multiple doctors arrive simultaneously, you could see big, unmanageable waves at the front desk. "This happens when schedulers assume that the new, young doctors can work as fast as the more seasoned doctors," Shuman said.

Tip: You should analyze how many patients your doctor can seein one hour. "And please don't bring in a comprehensive exam at the end of the day," Shuman said.

Evaluate Your Staffing Practices

In terms of staffing, Shuman urges practices to examine whether there are too many employees scheduled some days of the week and not enough on others. She also recommends you schedule everyone to have lunch together, "because this is how we build our teams."

You should have procedures in place for staff members, from the phones through checkout. Ensure that they are not only written down, but that they are also carefully followed, she advised.

Walk the Walk

One way to determine where to find weak links in clinical flow is to walk through your office as a patient. "Scheduling starts with the patient journey," she advises.

As you walk through the practice, ask yourself the following questions:

• Where are you retracing your steps?
• Do you have to go back to the main waiting room?
• How much are doctors walking to see patients?
• What about your wheelchair patients? Do they transfer to the exam chair?

Once you get a handle on your staffing and scheduling systems, asking these questions can help you perfect the flow so your practice will run more smoothly, Shuman advised.