Keep Patients Waiting Not in My office

Keep Patients Waiting? Not In My Office

Albert Hutchins

BUSN 6110

July 29, 2016

Prof. Pesi Amaria

INTRODUCTION:

Patient wait times have been a systemic problem in many places. Provider’s offices though are not as bad as hospital Emergency Rooms but are still a place where patients seems to get upset because of delays. There is a supply and demand problem throughout many areas of healthcare. In some areas of the United States there are delays in being seen as a new patient as much as 50 days. Some of this is due to the government reducing funding to where more offices are closing and that hospitals need to run lean so as to make productivity numbers forced upon them from administrators who answer to system number crunchers that never see patients.

Patients come in on-time and are forced to wait because the provider seeing them has gotten behind schedule for one of many reasons. Providers struggle with this situation as they want to see as many patients as they can see in a day so as to take care of their patients all while bringing in as much revenue as possible. These types of delays can cause for unhappy patients and in some cases are the reasons why some patients leave their provider in hopes of finding one the stays on-time better. Sometimes these patients are left feeling as though they are not as important as the emergent patient that was pushed to the front of the line ahead of them. Providers must find a way to both take care of their scheduled patients as well as those that walk-in with emergencies. Some have decided to allow for appoint times that will assist the doctors in not getting too far behind to where they can’t catch up. These provider offices seem care more about patient care and satisfaction then they are about making the most revenue. There are three common type of scheduling techniques used in the U.S. health care system; individual scheduling, block scheduling and modified block scheduling. Individual scheduling is when a specific patient is booked for a specific amount of time usually due to the reason why they are being seen. Block scheduling is when patient are seen on a first come first served basis. This type of scheduling work well for those walk-in and or emergent type of clinics. The third type is modified block scheduling which patients are assigned in smaller amounts to smaller segments of time through the day.  

In this case study Dr. Schafer has developed a system that assists his office in caring for his patients. By allowing for emergent and walk in time slots this has made it to where his office has been able to stay on-time with their patient appointment times. This increases patient satisfaction and makes for happier patients and their parents. By leaving open slots in their schedule the schedulers are able to ensure that they are doing their part to help the doctor not only stay on schedule but also care for their patients in a timely manner.

1. What features of the appointment scheduling system were crucial in capturing “many grateful patients”?

Patients hate waiting in a provider’s office. They appreciate greatly when they are seen on-time. Providers are trying to see as many patients as they can in a day so as to take care of them and also as the more patients they see the more money they make. To do this they have several examination rooms where patients can be pre-screened and await for the provider to come in to see them. Medical Assistants are utilized more and more rather than nurses taking vital and history. By having several exam rooms allows for the provider to see an average of 3 to 4 patients in an hour and thus helps them to stay on schedule. New patients are usually asked to come in earlier than their scheduled appointment time so as the needed paperwork for insurances and family history can be completed before the patient is scheduled to see the provider. The Medical Assistants are also utilized for treatment instructions explanation as well as follow up instructions. When scheduling patients it is imperative to remind them to be on-time so that the provider can see them as well as the other patients on their schedule on-time.

With this case referring to a pediatrics office and for those of us that have been there when the children are all not feeling well it can be a nightmare. Having the patients and the provider on time helps eliminate some of the unhappiness. For parents with injured or kids getting a well-child checkup they don’t want their child getting sick from those that have caught the bug that is going around.  

1. What procedures were followed to keep the appointment system flexible enough to accommodate the emergency cases, and yet be able to keep up with the other patients’ appointments?

In too many cases providers do not allow enough time for their patients never mind the add on emergent cases that will walk in. Providers also utilize the excuse of their emergent cases as a reason as to why they are not on time with their scheduled patients. These patients are usually not happy that they have to wait longer than their expected wait time because someone else’s kid was sicker than theirs. They frequently see this as that they made an appointment and so should the other people.

With this case the schedulers were instructed to leave some open slots throughout the day to account for the walk-ins and emergent cases and so as to assist the provider in getting back on time with their scheduled patients.

1. How were the special cases such as latecomers and no-shows handled?

For patients that are habitually late a provider must take a stance so as to not cause the patients that are on time any unhappiness. If nothing is done then the provider will lose some of their good patients because of the few that can’t make it to their appointments on time. There are different ways to deal with patients that are late. Some try to reschedule them to another time so as to not upset the patients that are on time and waiting for their appointments. With no-shows many providers charge a no show fee if the appointment was not rescheduled within 24 hours of the scheduled appointment time. There are sometimes when a provider will even terminate a patient (no longer provide service to the patient) because of frequent tardiness or no-shows.

With this case the receptionist was responsible to contact the patients to reschedule their appointment to another day. If the patient arrived before the call was made them the patient was told they would be seen when the provider when the provider could fit them in but they were taking care of the patients that were on time first. They would then annotate in the patients chart about the delay (so as to have documentation). In the case of no-shows an entry is made in the patients chart. Documentation is kept tracking how many no-shows the patient has had and that any further no-shows the patient would be billed for their missed appointments.

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