APPOINTMENT SCHEDULING: KEY TO CLINICIAN PRODUCTITY & CLIENT ACCESS

Transcription

1 APPOINTMENT SCHEDULING: KEY TO CLINICIAN PRODUCTITY & CLIENT ACCESS

2 HRSA Disclaimer Community Health Partners for Sustainability, a program of the National Nursing Centers Consortium, is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U30CS09736, a National Training and Technical Assistance Cooperative Agreement (NCA) for $450,000, and is 100% financed by this grant. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.

3 Questions are welcome during the presentation

4 Today s Presenter Sue Gadon, MPA Health Care management consultant SDG Health

5 APPOINTMENT SCHEDULING KEY TO CLINICIAN PRODUCTITY AND CLIENT ACCESS Presented by: Susan D Gadon April 2, 2015 sdgadon@aol.com

6 OBJECTIVES As a result of this presentation, participants will be able to: Explain the impact of appointment schedule design on client access to services Identify benefit and challenges in appointment scheduling methodologies Construct an appointment template that maximizes client access 6

7 APPOINTMENT SCHEDULE TEMPLATES The ideal appointment schedule template serves the needs of staff and clients The template should create a steady stream of clients throughout the workday Results in maximum staff productivity and minimum client wait time 7

8 Why are appointment templates important? A well designed patient appointment schedule impacts: Healthcare provider productivity Client cycle time Clinic Flow Client wait time for appointment(s) Fiscal reimbursement Meeting funder requirements and goals Client and staff satisfaction Client healthcare outcomes 8

9 How do you design an appointment template to maximize access? 9

10 FIVE STEPS OF APPOINTMENT Scheduling 1. Assess clinic capacity to ensure visit goals are realistic 2. Develop client visit and unique client program goals 3. Select schedule methodology 4. Select schedule framework 5. Incorporate scheduling principles that promote efficiency 10

11 STEP 1: Assess Capacity and Demand Capacity is the number of clients that can be seen. It is a function of the total resources of the agency. Demand is the total client requests for care. 11

12 STEP 1 ASSESS CAPACITY AND DEMAND Key Resources- Capacity 1. Number of clinician FTEs 2. Clinical hours available to provide services 3. Average clinician time per client visit 4. Enhanced assessment of capacity: physical facilities, equipment, processes Key Resources- Demand 1. Client request for services 2. Percent of users seen in clinic per day 3. Variation by day, season, and provider 12

13 STEP 2: Develop Patient Visit Goals Based on capacity and demand analysis Review of trends 13

14 STEP 2: Develop Patient Visit Goals What is the goal for visits annually What were the visits for last year? Have these visits been increasing or decreasing? What are you productivity standards for Providers? 14

15 CALCULATING CAPACITY 1. Average Clinician Contact Time - 16 minutes 2. Average Possible Visit per Hour - 60 min in an hour / 16 min per pat = Productive Hours per Day hours 4. Potential Capacity Per Day pat per hour X 6.5 patient per hour = 24 per day 5. Total Capacity per Year - 24 per day X 200 days per year visits per clinician What is a realistic daily goal of patients per day per clinician? 15

16 CALCULATING CAPACITY Goal Capacity is 18 visits per day PER CLINICIAN

17 CALCULATING CAPACITY Goal Capacity is 18 visits per day for Clinician There are a 2 full time clinicians Each clinician works in clinic 200 days per year Thus the total capacity is 18 visits per day multiplied by 2 clinicians multiplied by 200 days per year THE TOTAL CAPACITY IS 7,200 visits per year 17

18 WHAT IS HAPPENING THAT THE SITE IS NOT OPERATING AT CAPACITY? 18

19 Limiting Access Time Visit Category 8:00 New Client Exam 8:15 Problem 8:15 Annual 8:30 Immunization 8:45 Revisit 9:00 Immunization 9:15 Revisit 9:30 New Client Exam 10:15 STD Check Time Visit Category 1:15 Problem 1:30 New Client Exam 1:45 Recheck 2:00 Annual Exam 2:45 Recheck 3:00 Revisit 3:15 Problem 3:30 Immunization 3:45 Problem

20 STEP 3: Select Schedule Methodology Single Interval Multiple Interval Block or Wave Interval Modified Wave 20

21 SINGLE INTERVAL Time Visit Category 8:00 Recheck 8:00 Problem 8:20 New Client Exam/Annual 8:40 New Client Exam/Annual 9:00 Recheck 9:20 Problem 9:40 Recheck 10:00 New Client Exam/Annual 10:20 Recheck/Method Time Visit Category 1:20 Recheck 1:20 Problem 1:40 New Client Exam/Annual 2:00 New Client Exam/Annual 2:20 Problem 2:20 Recheck/Problem 2:40 Recheck 3:00 Problem 3:00 Recheck/Method

22 STEP 4: Select Schedule Framework Traditional Do last months work today Carve Out Do some of today s work today Open Access Do today s work today 22

23 Open Access A patient s ability to schedule an appointment with their provider the same day or within a couple of business days Based on one guiding principle: Do Today s Work Today Requires a systematic paradigm shift in clinic operations 23

24 STEP 5: Incorporate Principles of Efficiency Reduce schedule complexity Reduce scheduling restrictions Reduce appointment type variability Standardize appointment type/length Average clinician time per visit Limit availability of schedule Don t schedule too far out 24

25 STEP 5: Incorporate Principles of Efficiency Incorporate Appointment No Show Rates Example: Clinic A Capacity: 21 visits/session No Show Rate: 30% (21visits/sessionx.30 NS Rate = 6.3 visits will not show up) In order to operate at capacity, Clinic A s Appointment Schedule should make available 27 appointments for each clinic session. However, if 27 clients showed on one day, would the staff be able to serve? 25

26 STEP 5: Incorporate Principles of Efficiency Establish a script Create contingency plans Establish a policy for late patients Establish policy for early patients 26

27 Quality Assurance and Monitoring Routinely Monitor Patients Served per Day No Show Rate by Day of the Week and Time Walk-in Appointments by Day Time to Next Available New Appointment New Patient Appointments as % of Total Appointments Why Monitor?: Ensure that you are meeting funder goals and fiscal goals 27

28 Clinic A Expanded Schedule Incorporating No-Shows Time Visit Category 8:10 Office Visit 8:30 Office Visit 8:50 Office Visit 9:10 Office Visit 9:30 Office Visit 9:50 Office Visit 10:10 Office Visit 10:30 Office Visit 10:50 Office Visit 11:10 Office Visit 11:30 Office Visit Time Visit Category 1:00 Office Visit 1:20 Office Visit 1:40 Office Visit 2:00 Office Visit 2:20 Office Visit 2:40 Office Visit 3:00 Office Visit 3:20 Office Visit 3:40 Office Visit 4:00 Office Visit 4:20 Office Visits

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30 Thank you for joining us today!