With increasing revenue pressures, practices know that effective patient flow is key to increasing revenue and improving efficiency. Every step of the patient flow from parking to check-out needs to move seamlessly, so that providers can operate efficiently and maximize time with patients.
By (1) minimizing undue waiting, (2) making destinations within the practice obvious, and (3) ensuring timely transitions among staff, practices can make patients feel well cared for and maximize daily patient load. By studying patient flow, providers have been able to increase efficiency and uncover hidden capacity and, as a result, improved their patients’ happiness and health while increasing revenue.
Here’s three ways to improve patient flow:
1. Establish practice buy-in
Patient flow is not just up to the doctors — it’s a group effort, requiring full office alignment on goals. You can help advocate for improving patient flow by not just sharing the benefits for patients, but to the staff as well, such as getting home on time and generating higher income.
2. Chart your flow
Before you can improve your patient flow, you’ll need to identify the bottlenecks in your patient care process and understand their underlying causes using these two techniques:
- Flow mapping. Have volunteers visit your office as patients who will take detailed notes about their entire appointments. Ideally, staff will be unaware of their true purpose — you can hire a patient flow consultant to help set up these visits — but you can also go through a visit yourself. Make sure to record what happens during the appointment and any observations and impressions along the way.
- Cycle-time measurements. Measure and chart how much time each segment of a patient visit takes. Pay special attention to waiting times. Record the total cycle time, or the time it takes from a patient’s arrival to departure. Continue tracking these times to better understand the dynamics of your practice and identify the largest opportunities to improve patient flow.
3. Address your bottlenecks
Once you’ve identified the bottlenecks to good patient flow, you can start making adjustments to your processes. The most common bottlenecks include:
Often, staff will realize that they are missing critical test results or required documentation after a patient has already arrived for an appointment. To prevent cancelling an appointment during a visit, determine if all necessary information is available in patient charts the day before and reschedule if necessary. An electronic health record (EHR) can help by providing real time updates of lab and imaging results. Some EHRs also offer free customizable online intake forms patients can fill out at home with all information flowing directly into patient charts, eliminating manual entry.
Another effective visit planning approach is for providers and support staff to review their schedules together in order to identify how to make a day run more smoothly. For example, if a parent is coming in because one of his sons has a cough, but the doctor knows he’ll probably want his other children checked out too, staff can make sure all their charts are ready and any free nurses or doctors can plan to help. You can also view multiple facility and provider schedules side-by-side directly in your EHR to prepare for the best daily patient flow.
The layout of the office is critical for optimal patient flow:
- Place the receptionist near the entrance and enable the receptionist to view the entire room. The design of the counter at the reception area should allow patients to complete paperwork there.
- Exam rooms should be in close proximity to the waiting area. Consider how many exam rooms your office can handle at a time.
- The patient traffic flow should move sequentially throughout a visit without the patients ever retracing their steps.
- Consider the use of extra exam rooms to handle patients at high demand.
- Regardless of office design, if your practice over schedules patients, they will sit in a waiting area and fume.
EHR Technology and Training
Often non-visit-related tasks that arise during the course of an average day slow down patient flow. Refill requests, phone calls and scheduling must all must be managed, and the most efficient way to do this is in real time, responding to these needs as they arise rather than dealing with them at the end of the day when you and your staff’s energy is at its lowest.
An EHR can speed up these tasks. From online booking and automatic insurance eligibility checks to e-prescribing and electronic ordering, an EHR offers free time-saving features that eliminate phone calls, faxing and manual entry. It’s often useful to have someone as the office EHR “super user” — someone fully proficient with the EHR — that can help train other staff and physicians.
Optimizing patient flow is a process
When trying to improve patient flow, test one small change at a time and make sure to record if your intervention is helping to move your practice towards its goal. With measurable goals in mind and the ability to tolerate some trial and error, you’ll be on your way to better patient flow and more satisfied patients and staff.