Ophthalmology and Optometry Coding Alert

Once you know the "true" schedule, you can create a system that keeps patients flowing through the practice.

Establishing a successful patient flow at your eye care practice depends on several factors, including staffing, scheduling, and even office layout to ensure that patients move through efficiently and leave happy. All staff members must be involved, from the receptionist to the physicians, to ensure that the flow is smooth and doesn't hit snags. Such was the advice offered at the recent American Academy of Ophthalmic Executives meeting. Read on for tips from the meeting presenters.

Tip 1: First, Crunch the Numbers

If you want to perfect the patient flow processes at your practice, start by evaluating the data you have on-hand, including schedules, current clinic wait times, and billing reports, advised Ashley Villegas, COE, OCS, practice administrator at a retina practice in Amarillo, Texas.

If you are adequately staffed and still underperforming, you need to identify the problem, train, and if necessary, let someone go. In addition, you must identify staff members in every department who are team players that can answer all of your questions. "Build those people up and make them trainers," Villegas said.

Tip 2: Consider A "Lean Office Flow" Model

Whereas many busy retina practices take about two hours to get patients in and out, that time can be cut significantly for practices that employ lean office flow models. Lynn Tamborini, practice administrator in Peru, Illinois, said established patients typically spend 45 minutes in her office when they present to see the retina specialist, thanks to the lean model.

The lean model at her practice starts with an efficient design system set up like a large circle and featuring three workup rooms and a back waiting room where patients can wait while they dilate.

Among the most important features is that the doctor never has to wait for patients to be ready to see him - the support staff always has the patient prepped and ready, so when the ophthalmologist is prepared to treat the patient, there is no lag time.

Tip 3: Scheduling Is Imperative

When creating a schedule, find out which format works best with your staff. For instance, Tamborini found that it was inefficient to use an EHR for flow scheduling, because the office techs said they prefer to use written, highlighted schedules.

Another important factor when it comes to scheduling is that the physicians are the main people to evaluate when trying to determine how many patients should be scheduled in a typical day, Villegas said. "Everything begins and ends with the doctors. They are the pacesetters," she said. You should spend a few days observing the physicians to evaluate how many patients they can realistically see in a day and not base your scheduling criteria on how many patients the doctors say they can see.

It's okay to overbook slightly to account for no-shows, but it's important not to overbook by too much, because your practice simply won't have enough examination rooms to hold the overflow.

Tip 4: Consider These Factors When Analyzing Office Flow

To calculate how much time you should allot for each patient, spend a few days counting the actual time that your office services take along with the other important variables necessary to create a schedule, Villegas advised. Factors you should evaluate include the following:

• Number of patients the doctor can see in an hour. Note that the doctor will go faster when you are standing outside of the office with the clicker, she said.
• Number of patients the techs can work up and test per hour
• Types of appointments allotted throughout the day

You may also want to create similar templates for surgeries, injection clinics, laser clinics, clinical research, and satellite clinics, Villegas added.