Implementing Same-day Appointment Scheduling
Offer an appointment today to all who call.
Implementation
- Schedulers must completely reorient their way of thinking and function with a clear understanding of the intent of same-day scheduling and the goal of accomplishing today's work today.
- Many office processes must be reorganized to meet the "just in time" demands of same-day service. These processes include: medical records, office personnel and ancillary services.
Create contingency plans to accommodate occasional capacity/demand mismatches.
- Schedule physician-out times around predictable high-demand seasons.
- Adjust physicians' work schedule to stabilize the amount of daily capacity.
- Use mid-level providers who do not have their own patient panels to meet excess daily demand variation.
- Use a double-block scheduling system to adapt for physician vacation time. For each week of vacation, block off two weeks of the schedule. The day the physician starts his or her vacation, 50% of the following week opens for scheduling; the day the physician returns, the remaining 50% of the slots open. This allows for a temporary, predictable creation of backlog while still maintaining same-day scheduling.
Create capacity and shape demand.
- Reduce patient return-ratios by decreasing the frequency with which you arbitrarily see many chronic-condition patients.
- Maximize the care provided at each visit to reduce unnecessary return visits.
- Minimize prescheduling of return visits.
- Establish minimum staffing policies for the practice and stagger "physician-out" times, thereby avoiding unnecessary physician shortages.
- Explore the various types of group medical visit appointments in order to leverage valuable physician time.
- Establish care-team systems and protocols for chronic-care management in order to optimize use of nursing skills and apply physician time toward more urgent needs.
Note: Many of these suggestions seem counterintuitive in a fee-for-service system with today's reimbursement needs. However, they allow for growth of a practice and an increase in a physician's panel size by opening access to new patients.
Evaluate Success
Transfer data from the number of appointment requests tally sheet to the Excel spreadsheet, which will automatically calculate the percentage of same-day vs. pre-scheduled visits.
You may also record the number of days until third available appointment on the Excel spreadsheet, which will automatically calculate an average. Measure this statistic on a weekly basis until same-day scheduling is accomplished.
During the backlog reduction period, the wait for the third available appointment will gradually decrease until it can be maintained at a same-day level. Continue to monitor this statistic on a periodic basis.
Evaluate cost-effectiveness:
Evaluate Success
Transfer data from the number of appointment requests tally sheet to the Excel spreadsheet, which will automatically calculate the percentage of same-day vs. pre-scheduled visits.
You may also record the number of days until third available appointment on the Excel spreadsheet, which will automatically calculate an average. Measure this statistic on a weekly basis until same-day scheduling is accomplished.
During the backlog reduction period, the wait for the third available appointment will gradually decrease until it can be maintained at a same-day level. Continue to monitor this statistic on a periodic basis.
Evaluate cost-effectiveness:
- Same-day scheduling coincides more appropriately with present demand. Thus, expect a rapid decrease in the number of no-show patients, as fewer appointments are deflected to a future date. The number of patient- and provider-initiated cancellations will also drop off.
- Maximum packaging of care per visit will result in higher reimbursable visit value.
- Revenues will increase due to a higher retention of patients (fewer visits will be shunted to other sources, such as urgent care centers and emergency rooms).
- Proper reallocation of nonclinical work to other staff will increase overall staff productivity. Physicians and nurses will have more time to spend with patients.
- Anticipate an overall growth in the physician panel size. The same-day schedule allows for an increased number of new patient visits and a decrease in the return-ratio of established patients.
Evaluate Satisfaction
Distribute a patient satisfaction survey before, during and after implementation of same-day appointment scheduling. How do patients feel about the option for a same-day appointment? Does the change to same-day scheduling improve their overall satisfaction with the management of the practice? Do they feel they're getting better quality, more timely care?
Anticipate increased satisfaction among physicians and other staff members in the practice, as well. Physicians will feel that they're able to see their own patients more often, and that their patients are more satisfied with the treatment they receive. All staff members will enjoy treating patients in a more timely manner.
Increased staff satisfaction yields secondary results: An enjoyable work environment encourages valuable staff to stay at their jobs, which in turn increases productivity and cuts down costs for recruiting and training.
Distribute a patient satisfaction survey before, during and after implementation of same-day appointment scheduling. How do patients feel about the option for a same-day appointment? Does the change to same-day scheduling improve their overall satisfaction with the management of the practice? Do they feel they're getting better quality, more timely care?
Anticipate increased satisfaction among physicians and other staff members in the practice, as well. Physicians will feel that they're able to see their own patients more often, and that their patients are more satisfied with the treatment they receive. All staff members will enjoy treating patients in a more timely manner.
Increased staff satisfaction yields secondary results: An enjoyable work environment encourages valuable staff to stay at their jobs, which in turn increases productivity and cuts down costs for recruiting and training.
