Origin of Inefficient Schedules
We do it that way because that is the way its been done is a common but lousy answer.
Appointment Types Are Setup When You Know the Least
With most new systems, you need experience to be good, and this is clearly true of scheduling. Many times, the scheduling system is created and implemented when the electronic health record (EHR) system is new or when a practice is first opening. Even if a new EHR system is obtained, the old scheduling methods are moved into the new platform. Every good system needs to be monitored and updated regularly. Appointment types and templates should be reviewed at least yearly. Make sure your system evolves with you and the realities of care you deliver.
Eager to Get Going
If you are like most people, you want to just get started. Take the time to go through the steps and create what you want, what you need, and what will bear fruit. Leveraging technology can get you up to speed more quickly. But nothing can replace careful planning.
Creating and Using Meaningful Appointment Types – The Process
Identify the members of the team who are needed to build an optimized schedule. This means understanding the process from inception to completion. Get input from a responsible staff member for each step in the process–including providers, nurses, medical assistants, schedulers, and receptionists.
Schedule a meeting for building appointment types and templates at a time that does not conflict with clinical duties. Interruptions and competing interests will rob you of success.
Create a list of all appointment types. Assign homework before the meeting. Each participant should be able to provide a comprehensive accounting of the duties and time needed to complete any specific task they do. This will help you understand the problems and find the needed solutions. The process can then be streamlined, and many repetitive tasks diverted into automated systems.
Decide on the appropriate template and appointment types. Create a master catalog of the templates and their contents. Assign specific individuals to create templates and update appointment types.
Revisit and Revise
Optimization is a moving target. Plan to revisit this and all protocols on a regular basis.
Problematic Appointment Type
Improve patient flow by avoiding the common problems.
New Patient Appointments
For the small office or solo practitioner, new patient appointments are not likely to be a big problem. For the larger office or multispecialty group, these appointments can be vitally important. Different types of new appointments could easily have different visit times or potential associated testing.
Standardize the verbiage for follow-up visits. Specify the time and any special needs for that visit. Then place all the information into the schedule and store the original in the notes fields of the EHR.
For post-operative follow-up, schedule the appointment with notation of the procedure that was performed. Many post-operative visits must have pre-visit testing for the visit to be truly meaningful. Make sure these requirements are built into the system. Be mindful of special instructions and exceptions to your standard scheduling guidelines.
Physical Examinations and Wellness Visits
If your practice has a large volume of a certain visit type such as an annual wellness visit or a coordination-of-care visit, create appointment types with the associated guidelines for that visit and any special instructions.
Be thoughtful and methodical. Don’t skimp on the planning. Most importantly, get started. The schedule is the heart of the business of medicine and the delivery of care. We must optimize the schedule in order to make real progress optimizing the whole practice.