Efficiency pleases patients, saves money
Efficiency pleases patients, saves money
Study links well-organized office’ to satisfaction
Physicians stay on time and sometimes see patients early. Staff handle whatever task is required at the moment. Managers maintain standards and monitor performance.
Those qualities and other operational efficiencies led to an average annual savings of $450,000 to $700,000 per clinic, according to an analysis of the better performers in the ambulatory clinics benchmarking project of the University HealthSystem Consortium (UHC), an organization of university-affiliated health systems based in Oak Brook, IL, that collaborates on research projects. (For key findings, see p. 168.)
Productivity and customer service went hand-in-hand. "All of these [high-performing] clinics tended to have high patient satisfaction," she says. "[The patients] didn’t seem to feel they were being short-changed,"says Danielle Carrier, MBA, program director in operations improvement for UHC.
UHC’s patient satisfaction survey showed that a well-organized office was one of the leading factors influencing patient satisfaction ranking even higher than waiting time, Carrier says.
What made the difference? In one word: staff.
Better performers had more staff per physician full-time equivalents. Staff had flexible schedules and performed multiple tasks. And staff often teamed up with a particular physician or set of physicians.
"You didn’t necessarily have to have an RN [assisting the physician]," she says. "You could have a medical assistant if that assistant was comfortable with that physician’s work style, and the physician was comfortable with the medical assistant’s effectiveness."
The UHC project studied four clinic types:
1. general internal medicine;
2. family practice;
3. orthopedics;
4. hematology/oncology.
At one group studied, the University of Kentucky’s Internal Medicine Group, staying on time rates as a top priority.
Each day, medical records staff pull charts for the following day’s patients. Then, clerical staff arrive at 7 a.m., even though the first patient won’t come until 8 a.m. They complete as much pre-registration as possible, so information such as address and phone number simply needs to be verified when the patient arrives.
Try flexible work schedules
Flextime helps accommodate that schedule. Since the clinic is busiest early in the week, and those employees work 7 a.m. to 5 p.m., they receive alternate Friday afternoons off. Meanwhile, clinic staff ask patients to arrive for their appointments at least 15 minutes early to allow time for registration.
Physicians have productivity standards; they are expected to see an average of 12 relative value units (RVU), which translates to about 12 patients per half day. RVUs assign greater weight to patients or procedures that require more time. For example, checking for an ear infection would have a lower RVU than a physical exam.
The physicians see scheduled patients every 15 minutes, except at the 45-minute mark. That extra slot every hour allows for patients to be scheduled for longer visits or for urgent cases to be added. A physician’s assistant covers a call-in clinic, where patients can receive a same-day appointment.
With all those efforts, the Internal Medicine Group has average wait times of seven minutes or less.
At University Orthopedics and Sports Medicine at the University of Cincinnati, cross-training and a physical redesign have helped streamline the flow of patients through their appointments. Some tasks, such as X-ray requisitions and chart preparation, have been shifted from clinical staff to medical secretaries, says practice manager Linda Stamper.
The practice has three receptionists: One sends patients to X-ray, one handles appointments for physicians, and one handles physical therapy appointments. Now, those three are interchangeable. They help each other out and understand the importance of such issues as making sure patients have correct referrals that include physical therapy so patients’ treatments aren’t delayed.
A floor plan redesign helped improve communication among staff. The secretaries’ desks are now near clinical staff and physicians. The billing staff work directly behind front desk people, so they are available to talk to patients about billing and coverage issues.
Transcriptionists were once in the center of the room but now are located in a remote corner so noise around them is minimal.
"By changing everything around, we actually gained additional space for five staff," says Stamper.
Subscribe Now for Access
You have reached your article limit for the month. We hope you found our articles both enjoyable and insightful. For information on new subscriptions, product trials, alternative billing arrangements or group and site discounts please call 800-688-2421. We look forward to having you as a long-term member of the Relias Media community.