Practice Management Alert

Improve patient satisfaction to prepare for the value-based care era.

Take a look around your waiting room. Now ask yourself, is your practice patient-centered or revenue-centered? The two aren’t necessarily mutually exclusive, especially as MACRA and MIPS make the patient experience a component of “value-based care.”

Now, look around your waiting room again. A constant flow of patients in and out indicates a robust patient population, but is your flow steady? While many providers claim to put patients first, the number of people waiting quietly (or not so quietly) in their lobbies suggests that’s simply not the case.

With the constant pressure of decreasing reimbursements, the urge to pack your schedule with patients is understandable. But for every vocal patient who brings her wait to your staff’s attention, there are others who will fill their time in your waiting room searching for a new provider on your Wi-Fi.

Determine and provide realistic expectations

To avoid that unwelcome outcome, there’s no need to speed through exams or schedule fewer patients. Focus on your processes and problem solve. If you consistently find yourself behind, it’s time to reassess your approach to patient flow.

Practices commonly schedule patients based on what they hope to be doing, or feel like they should be doing. Unrealistic expectations are why a schedule that seems fine on paper goes sideways. Your schedule should be based on the actual, measured time the doctor needs to see his or her patients.

Embrace reality. Design a schedule according to the data you’ve collected, not what you think is happening in the office. Use your EHR to accurately gauge just how long exams and procedures take, and schedule accordingly.

When scheduling both new and current patients, let them know how long they can expect to be in your office. This will help them to know when to schedule other activities or appointments during their day. When squeezing a patient into a busy schedule, remind them that they may need to wait.

Introduce efficiencies on the front-end

When interacting with patients during scheduling, use a standard script to ensure staff asks all of the right questions, including identifying the reason for the visit and any special circumstance that could affect the length of the appointment.

This is also an opportunity to remind each patient of your broken appointment/late patient policy. Over time you will reduce the risk of no-shows, excessively late arrivals, and last-minute cancellations. Make it part of your appointment staff’s script and patient portal instructions.

Urge new patients to complete their paperwork prior to reaching the office, and remind returning patients to bring a list of changes to their medications and medical history. Make sure that all consent forms are signed and diagnostic imaging completed prior to any physician exams. Encourage them to use your patient portal whenever possible to reduce waiting time for them and input time for your staff.

Use technology (like your EHR) to monitor patient flow, identifying recurring problem areas and restructuring your workflow when necessary.

Put out fires

When a problem does arise, don’t ignore it. Inform patients in your waiting room of any delays; they’re likely just as busy as your office. And if there is a wait, try thanking your patients for their patience. If the delay is significant, consider calling patients who have not yet arrived.

Consider adding the role of an office flow maestro. Your most experienced clinical support staffer can conduct morning briefings to review potential bottlenecks, problem patients, or special circumstances for that day. Having a pair of eyes on routine problems is the first step to identifying and solving them.