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How to Reduce Patient Wait Times?

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On Patient Satisfaction

[By Dr. David Edward Marcinko MBA]

DEM blue

The traditional linear patient scheduling system is slowly being abandoned by modern medical practitioners; in all venues (medical practices, clinics, hospitals and various other healthcare entities).

Why? Waiting room times are too long!

According to this infographic put together by the folks at evisit.com the amount of time patients spend waiting in your office have a huge effect when it comes to patient satisfaction.

For example, did you know that the national average wait time is currently around 21 minutes!

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reducepatientwaittime_infographic

 [Click to Enlarge]

Patient Scheduling Issues

Most mature doctors follow a linear (series-singular) time allocation strategy for scheduling patients (i.e., every 15 or 20 minutes).  This can create bottlenecks because of emergencies, late patients, traffic jams, absent office personal, paperwork delays, etc.

Therefore, as proposed by colleague Dr. Neal Baum MD, a practicing urologist in New Orleans, one of these three newer scheduling approaches might prove more useful.  

1. Customized Scheduling

The bottleneck problem may be reduced by trying to customize, estimate or project the time needed for the patient’s next office visit. For example:  CPT #99211 (5 minutes), #99212 (10 minutes), #99213 (15 minutes), #99214 (25 minutes), or #99215 (40 minutes). Occasionally, extra time is need, and can be accommodated, if the allocated times are not too tightly scheduled.   

2. Wave Scheduling

Some patient populations do not mind a brief 20-30 minute wait prior to seeing the doctor.  Wave scheduling assumes that no patient will wait longer than this time period, and that for every three patients; two will be on time and one will be late. This model begins by scheduling the three patients on the hour; and works like this. The first patient is seen on schedule, while the second and third wait for a few minutes.  The later two patients are booked at 20 minutes past the hour and one or both may wait a brief time. One patient is scheduled for 40 minutes past the hour. The doctor then has 20 minutes to finish with the last three patients and may then get back on schedule before the end of the hour. 

3. Bundle Scheduling

Bundling involves scheduling like-patient activities in blocks of time to increase efficiency.  For example, schedule minor surgical checkups on Monday morning, immunizations on Tuesday afternoon, and routine physical examinations on Wednesday evening, or make Thursday kid’s day and Friday senior citizens day. Do not be too rigid, but by scheduling similar activities together, assembly-line efficiency is achieved without assembly line mentality, and allows you to develop the most economically profitable operational flow process possible for the office.  

Patient Self Scheduling (Internet Based Access Management)

New software programs, and internet cloud applications, allow patients to schedule their own appointments over the internet. The software allows solo or individual group physicians with a practice to set their own parameters of time, availability and even insurance plans. Through a series of interrogatories, the program confirms each appointment. When the patient arrives, a software tracker communicates with office staff and follows the patients from check-in, to procedures, to checkout.

Today, many hospitals have even abandoned the check-in or admissions, department. It has been replaced by access management systems.

***

hospital

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Waiting Room Strategies 

In any potentially detrimental situation, delineate what the staff can do to make it right. A service paradox exists and timely, appropriate action can sometimes build more patient internal satisfaction than if the situation had never occurred.

Take the wait for example. It is not enough to just have policies in place that help prevent a prolonged wait from occurring. There must also be policies in place that ameliorate an adverse situation when it does arise. This can involve placating a patient over long wait, or, reassuring a patient about an empty waiting room.

  • An apology form you and/or the staff might be one technique, “I’m so sorry to keep you waiting. Doctor X and I really try to stay on schedule because we know how valuable your time is.”
  • Offering some refreshments might be another.
  • In extreme cases, giving the patient a beeper and turning them loose until you see them may work.

Many patients will be impressed you have even considered how the wait affects them. Sometimes the above management techniques, if the wait is not too offensive, can actually build more patient satisfaction than just seeing them on time.

Conclusion

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Medical School Ethics versus Business School Ethics

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Is Business Finally Embracing Medical Values?

[By Render S. Davis MHA CHE]

[By David Edward Marcinko MBA]

dr-david-marcinko

In the evolutionary shifts in models for medical care, physicians have been asked to embrace business values of efficiency and cost effectiveness, sometimes at the expense of their professional judgment and personal values.

While some of these changes have been inevitable as our society sought to rein in out-of-control costs, it is not unreasonable for physicians to call on payers, regulators and other business parties to the health care delivery system to raise their ethical bar.

Tit-for-Tat

Harvard University physician-ethicist Linda Emmanuel noted that “health professionals are now accountable to business values (such as efficiency and cost effectiveness), so business persons should be accountable to professional values including kindness and compassion.”

***

face-off

[Medicine versus Business]

***

Assessment

Within the framework of ethical principles, John La Puma, M.D., wrote in Managed Care Ethics, that “business’s ethical obligations are integrity and honesty.

Medicine’s are those plus altruism, beneficence, non-maleficence, respect, and fairness.”

About the Author

Render Davis was a Certified Healthcare Executive, now retired from Crawford Long Hospital at Emory University, in Atlanta, GA He served as Assistant Administrator for General Services, Policy Development, and Regulatory Affairs from 1977-95.  He is a founding board member of the Health Care Ethics Consortium of Georgia and served on the consortium’s Executive Committee, Advisory Board, Futility Task Force, Strategic Planning Committee, and chaired the Annual Conference Planning Committee, for many years.

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Conclusion

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