A changing landscape drives the need for change in healthcare operations
The United States healthcare industry is undergoing a dramatic change as the Affordable Care Act (ACA) pushes healthcare organizations towards increasing efficiency in order to remain profitable. A primary driver of the success of a healthcare practice is without a doubt the clinic operations. Without managing and improving the funnel of new patients coming through the clinic, it is very difficult to sustain profitability in the long term. Administrators know that their practices need to become more efficient, but the question is: “Where do we start?”
Analyzing 4 critical components to scheduling
At Tefen, scheduling is one of our first areas of examination as it impacts almost every other process in the clinic. As part of Tefen’s Lean 360 for Healthcare offering, we analyze scheduling by breaking it down into 4 critical components:
There are many more considerations and questions to be asked to truly understand current scheduling practices and where performance gaps exists, but digging deep into these 4 critical areas makes up the 80% of the 80/20 rule.
Designing an optimized patient scheduling system
Once a current state gap analysis is conducted, design of the new Structure, Rules, Processes, and Tools can begin:
- Structure – Typically a form of centralization will benefit the practice by reducing the resources dedicated to scheduling (typically, by >30%) and increasing standardization and adherence to rules. It is important to note that the same structure may not work for every practice.
- A practice with a young patient base, such as a university, may be able to use a web based interface where patients select appointments from available slots.
- A practice with a more elderly patient base, such as geriatric care, will find it more beneficial to have scheduling done over the phone with a live person.
- Rules – Once the new structure is designed, rules need to be defined on how to handle incoming appointment requests. In order to schedule in a standardized manor, each condition and appointment type needs to have rules around it which meet the needs of each physician and the patients they care for. Properly designed rules should dramatically open access for new patients allowing for next day appointments and the ability to handle same day emergencies.
- Processes – Once the rules have been defined, the scheduling process needs to be standardized. Using lean methodologies will prove helpful in reducing variation and waste in the process resulting in an additional decrease in resources required and an increase in patient satisfaction.
- Tools – Finally, tools should be developed that condense the rules into easy to follow workflows that error-proof the process. These tools should be intuitive and quick. A couple examples of helpful scheduling tools are:
- Comprehensive call scripts – which allow users to quickly react to a patient’s needs and follow simple decision trees based on the referral and appointment types
- Scheduling pathways (example below) – which in addition to identifying the urgency level and the correct physician for the patient’s condition show the user the selected physician’s pre visit requirements (scans, labs, referring MD’s notes etc.) for that specific condition.
An example of a Tefen Scheduling Pathway Tool
In the images below you will see an example of one of Tefen’s Scheduling Pathways tools used by schedulers to take a call from any patient and process it into a properly planned visit for any physician. The scheduler first selects an incoming condition, then identifies the correct physician to treat that patient, finally they press the highlighted button so they can tell the patient what diagnostic testing, scans, or other information the patient will need for the physician to be able to treat their condition.
When evaluating the current state of your practice’s clinic, ensure that an evaluation of your scheduling is a primary component, and that all other process improvements are maintaining and enhancing the ideal schedule for your Physicians and their patients. This will allow you to reduce lead times to appointments, patient wait times, and physician downtime while maximizing patient satisfaction and throughput.
This is just a starting point for improving clinic operations, for more information on the application of Lean 360 in the healthcare industry or Tefen’s Scheduling Optimization programs feel free to reach me at firstname.lastname@example.org.
-By Tom Ambrogio, Sr. Consultant Tefen USAHealthcare, Scheduling