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Part B Insider (Multispecialty) Coding Alert

SCHEDULING:

Adjust Your Capacity to Make Same-Day Scheduling Possible

Published on Tue Dec 30, 2003

Seeing today's patients today -it seems like such a simple, beautiful idea. Experts say same-day scheduling or "open access" can increase a practice's efficiency and make patients happier.

But moving over to same-day scheduling can be a huge challenge for a practice that's already scheduling patients two months in advance. How do you get rid of that backlog of patients while also moving toward leaving more appointment slots open?

"If you're starting a practice or taking over a practice, it's much easier," says consultant Martin Blume with Eagle Medical Management in Scottsdale, Ariz. But for practices that are moving over to same-day scheduling from the traditional model, experts offer these tips:

  • Eliminate the backlog while seeing new patients. Think of the patients waiting for physical exams and other visits as people standing in a line, says John Otterson, director of ambulatory service design at the University of Wisconsin Hospital and Clinics. You don't want to move the people at the end of that line forward, but you also don't want to add more people to the end of that line.

    Increase your capacity for a while. Otherwise, your doctors "are going to be way over capacity for a couple of months," Blume says.

    "Hire a locum tenens," Blume says. Or else if you're already planning on bringing in a new physician assistant or nurse practitioner, add that person at the start of the double-booking period.

    Have one person who keeps track of scheduling complexities.  Otterson advises having an on-site clinic manager who coordinates same-day scheduling.

    Don't look for a magic formula. Some experts advise basing your same-day slots on a set percentage of your overall patient census, but Blume and Otterson say it's not that simple. "You do it a little bit by trial and error," Blume says. With multiphysician practices, the number of open slots every day may vary for each physician. The percentage of slots open at the start of the day may vary by specialty as well, Otterson says.

    Vary your percentage of open slots by day of the week. "Look at your records and see what your biggest days are," Blume says. If most patients call up on Monday and Friday, move as many routine visits as possible to the other three days.

    "A lot of people are afraid that when they get into open access, all these people are going to call to get physicals today and the schedule is going to be packed," Otterson says. But this tends not to happen if you've accurately predicted the fluctuations in demand and adjusted your schedule to fit. "You're not going to double-book - that's the payoff."

     

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