“Yes, excuse me? Um, my appointment was scheduled for 1:30. It’s 1:48.”
You’ve heard that line and, possibly, delivered that line. Nobody likes that line. That line represents a cost in emotional and financial terms. So, how do we make that line obsolete?
In fact, we have a few ideas. Like them, love them, or hate them, here are several ways to reduce patient wait times at your medical practice.
A word of warning, though: Wait time in and of itself isn’t the ultimate metric. Studies among cancer patients have indicated that the cause of a wait isn’t necessarily correlated with a patient’s favorable/unfavorable perception of a wait, and that a patient’s feelings about a wait depend on more than just raw minutes off the clock. On top of that, a group of orthopedic patients indicated that time with their physician, play a bigger role in - or at least was more associated with - satisfaction than wait time.
A 2016 study looking at blood collection appointments in a cancer clinical trial showed that using an “automated patient check-in system” was one contributing factor to cutting wait times by almost 20%. It’s the digital age; why are we still using hard-copy sheets? Numerous automated check-in services exist, and provide benefits like accurate time reporting, streamlined metrics, and alert systems that don’t necessarily rely on someone on your staff yelling across the room. Some allow patients to manage their insurance information, as well, saving your front-office staff time.
This idea gets to the broader issue of being on the lookout for new digital tools for, well, anything. There are countless startups in the healthcare and health IT industries trying to fix all of those annoying inefficiencies you deal with on a daily basis. We know because we’re one of them, and we’re friends with a lot of the others. If you see something in your practice that you think could be solved with a digital tool, there’s a decent chance someone is working on it. It’s true that the elderly still prefer to use the phone and a pen, but younger patients will be comfortable with these services.
A second intervention in the study linked above was to prepare as much as possible before opening the clinic. In their case, this included getting blood collection materials together during the night shift, which is probably not applicable to your practice. Still, reviewing orders, skimming appointments for any notable features that could take extra time and effort or consideration by the provider, all could reduce the chance you’ll be scrambling to get things ready on the fly when the patient arrives.
This is a big shift for most practices. We understand that this isn’t a small tweak, but a change in your underlying business model. The idea of setting aside part of your providers’ workday to remote appointments, or dedicating a provider to telemedicine, is uncomfortable. On the other hand, delivery of healthcare is shifting. With the increasing emphasis on preventative measures and lifestyle counseling, along with changes in reimbursement policy, primary care providers have a great opportunity in the form of telemedicine. Follow-up appointments for certain acute situations (e.g., post-surgical) may be an option, as well.
Obviously, this is a complex suggestion that’s a lot easier to make in a blog post than implement in an actual practice. Still, it’s fair to at least ask if you have any margin for bringing on an NP or PA to help ease the burden and see more patients. Or, if it’s worth hiring an extra part-time staffer to help at the front desk a few hours a week. Efficiency pays for itself, so - and you already know this - a great employee is your biggest asset. Additionally, you may be able to free up some cash to pay those for those hours by cutting down on unnecessary services. For example, BeckonCall’s on-call management system is easier to use and less expensive than traditional answering services that we still find in doctors’ offices. Just saying…
Designate specific roles for your office staff so that one person isn’t bouncing between to-dos. This should speed things up and improve your patient’s mood, since your front office rep won’t be interrupting check-in procedures by answering the phone all the time. Impossible? See the previous item.
No, not the physicians, the patients. A 2014 study published in BMJ Open showed that patients arrived earlier (or, as the authors say, “unpunctuality was reduced”) when office staff laid down the law. Patients were told they’d be rescheduled rather than seen if they showed up late. Turns out, that’s a pretty compelling incentive. Over the course of a year, patient arrival times got earlier, which has two major benefits. First, some clinics may be able to get early-arriving patients back to their provider ahead of schedule. However, even when this isn’t possible and wait times aren’t reduced, there is a second benefit because you…
People view pre-appointment waiting differently than waits that come after their scheduled time. Here’s how that BMJ Open study puts it: “In other words, when cycle times were measured from appointment times, they were reduced when unpunctuality was reduced. Less of the patient waiting time occurred after the appointment time. This shift is important even if waiting times are not reduced because several researchers have verified that customers view waits before the promised service time very differently from waits after the promised service time.” People expect to wait when they’re early, so you win just by getting patients in the door ahead of schedule.
Survey the people coming through the door for 1) their frustrations and 2) their suggestions. Sure, you’re going to get a lot of unrealistic input, but there’s a good chance you’ll find some really solid ideas, too. It’s the whole “think outside the box” thing. Without knowing what’s possible (or impossible), your patients will call it like they see it, and bring their own experience outside healthcare to bear on your inefficiencies.
No, don’t. That’s a joke. And a lousy joke at that, since there’s a good chance you already are missing meals and breaks to take care of your patients.
For an interesting and unconventional look at patient wait times, check out this post from the Institute of Healthcare Improvement. (Hint: what can UPS teach us about healthcare delivery?)
Topics: Practice Profitability