What type of scheduling works well when the staff knows how do you get relevant information from the patient so a real emergency can be handled promptly?

Same-day scheduling, also known as “advanced access” or “open access” scheduling, allows medical practices to dramatically decrease patients’ waiting times for appointments. Very simply, it requires that practices do today’s work today by offering a same-day appointment to all patients who call. The result is more timely care, increased patient satisfaction and improved practice efficiency.

While the concept has great potential and has garnered much interest, it is often misunderstood. The key mistake practices make is thinking of same-day scheduling as a ready-made product or a specific solution guaranteed to reduce a practice’s waiting time. In reality, there is no such product or solution; however, there is a proven process and a set of proven principles, which if applied in a customized fashion to each environment, will result in improved access to care. The course of action is similar to any quality-improvement process and involves four steps:

• 1) Assemble a team to address the problem;

• 2) Set an aim or a goal;

• 3) Make changes;

• 4) Measure to see whether your changes have resulted in an improvement.

The principles to apply throughout this process are fairly simple:

• 1) Understand, measure and achieve a balance between supply and demand;

• 2) Recalibrate the system (or reduce the backlog);

• 3) Reduce the number of queues by reducing the variety of appointment types or lengths (queuing theory);

• 4) Create contingency plans for times of heightened demand or lessened capacity;

• 5) Influence the demand (e.g., by matching patients with their own physicians, making the most of current visits and rethinking return-visit intervals);

• 6) Manage the constraints or bottlenecks (e.g., remove from the physicians any work that can be done by someone else).

Same-day scheduling, then, is really all about the process and the principles, not about a specific product or solution. It will require some thought, customization and experimentation to apply these principles to your specific environment. If you’re ready to embark on that, read on. What follows are commonly asked questions about open-access scheduling submitted by FPM’s readers.

KEY POINTS

• Under advanced access, practices do “today’s work today” by offering a same-day visit to all patients requesting an appointment.

• Advanced access is not a specific product or solution, but it involves a proven set of principles, which can be applied to individual practice environments.

• To begin eliminating waits, practices must ensure that the physician’s supply of appointments is balanced with patient demand for appointments.

Getting started

An appropriate panel size

Standardized appointment lengths

The trouble with carve-outs

Reducing backlog

Scheduling patients in advance

Patient preference

Part-time physicians

Preparing for visits

Keep your appointment book

Going it alone

Dealing with vacations

A team approach

Ready, aim, fire

The secret to failure

Patient scheduling. It seems like it should be simple. Scheduling patients is one of the most common tasks performed by practices...and it can also have a huge impact on your success. With 85 percent or more of a typical healthcare practice’s expenses fixed, ensuring patients are scheduled effectively and efficiently is critical to maintaining and maximizing your practice revenue.

You do what you can to keep missed appointments to a minimum and ensure your patients are seen by the doctor as close to their scheduled appointment time as possible. But there will always be patients who are running a few minutes behind, patients who require immediate emergency attention, or other unexpected events that put the entire day’s schedule behind. Whether it happens at the very beginning of the day or mid-afternoon, it is inconvenient and frustrating to both the patient and practice staff.

Patient scheduling in itself may seem like a simple process, but efficient patient scheduling is very significant and impactful to your patients’ delivery of care and your ability to keep wait times to a minimum so patient satisfaction stays high and practice profitability stays consistent.

Although you may not be able to control how on-time a patient is for their appointment, there are things you can do on the staff end to ensure the schedule stays fluid, or recoup time that is lost in order to get the schedule back on track whenever possible. Being able to master this will keep office stress to a minimum and make sure your wait times stay within reason.

1. Schedule from noon. Try your best to schedule morning appointments from noon backward and afternoon appointments from noon forward. Establishing this as the standard will help you maintain maximum productivity and ensure that the bulk of the day is scheduled out. If morning or afternoon slots don’t get filled, you can use those blocks of time much more efficiently by holding your staff meetings then, or cutting down on overhead costs by allowing staff members to come in later or go home earlier. Empty slots throughout the day generally result in unproductive down-time, so implementing a scheduling a patient scheduling system or appointment scheduling software strategy such as this will help reduce wasted time.

2. Implement patient self-scheduling . Did you know that the average phone call to schedule an appointment takes over eight minutes? Multiply that by the number of appointments scheduled each day and your practice may be spending hours on appointment scheduling each day. Some practices field all appointment scheduling calls to a designated person who may typically be a relatively low-paid employee. Or if you are a smaller practice, you may have only one staff member who handles pretty much all front office management tasks. With new advances in technology, this is now an area where you may be able to cut back on the unnecessary expense of an “appointment scheduler” and recoup a significant amount of time that could be spent on much more significant tasks. Studies show that the majority of patients prefer to schedule their own appointments online. Even better, 26 percent of appointments scheduled online are for the same day or the next day, filling up empty spots on your schedule. Practices now have the ability to offer real-time patient scheduling anytime and from anywhere with Internet access. Online scheduling is new to healthcare and offers greater convenience for both practice and provider.

3. Prioritize appointments. Patient visits vary in degree of time requirement and level of care needed. Consider these factors as you decide where and when to schedule your patients or whether you even need to put them on the schedule at all.  Many patient issues can be resolved with a brief phone call or email. Have the staff member who fields incoming calls use their best judgement to evaluate each call to determine whether to schedule the patient or have your nurse or doctor address the issue via a phone consultation. This approach ensures patients needing the highest level of care have better access to same-day appointments if necessary and practice profitability is maximized by treating patients with more complicated or significant medical concerns.

4. Confirm appointments with text and email appointment reminders. Utilizing an appointment reminder software system will improve upon the number of on-time arrivals and kept appointments. No-shows are costly and inconvenient especially when you are a particularly busy practice and have a good size waitlist. Both provider and patients miss out when a no-show occurs.

5. Create a patient waiting list. Last minute cancellations may be frustrating; however, with a patient waiting list, you are armed and ready when this unfortunate event occurs. Try using a patient scheduling platform that includes the ability to keep a list handy and ready to be notified. Being able to send out a mass notification of your immediate open slot is a huge time saver and revenue maintainer. Instead of grabbing the phone when you get that dreaded appointment cancellation, quickly access your stored digital patient wait list and send out a quick message encouraging your patients to call you rather than the other way around which results in a waste of precious time that could rather be spent on more productive activities such as getting to know your patients better or increasing billing collections.

6. Use Automated Patient Recare and Recall. Having a patient recall system in place ensures that patients return for their regular care appointments keeping your schedule consistently fuller. This type of system can also bring back patients who haven’t been in to see you for their regular care appointments in years by simply sending out a reminder email, text or voice call letting them know it’s time to reschedule.

 Every practice has room for improvement, and there are many ways you can increase office efficiency in order to keep processes running smoothly. If you find your practice schedule is consistently too full or not full enough, discuss this at your next staff meeting. Take note of which days if any the schedule seems to be more inconsistent. Establish these 6 effective medical appointment scheduling guidelines and make sure all staff members are adhering to them and then be open to other ideas that could help fill in the gaps and create a more fluid schedule.

Read our case study about the Surprisingly Big Impact of Online Scheduling and how one practice has seen new levels of engagement and efficiency through automation. 

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