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Fam Pract Manag. 2016;23(5):47

Answer patients' questions before the visit

Some patients save up questions, presenting their physician with the challenge of answering them all during a time-limited appointment. One of my patients and I developed a HIPAA-compliant solution several years ago that has dramatically increased our mutual satisfaction. Several days before his appointment, he emails me a one- or two-page document outlining his concerns and questions. I take a few minutes and type my brief answers in a contrasting font. My nurse gives him a copy when he arrives, and we use it as a discussion guide. I scan the document into the medical record and reference it in the progress note, entering the more significant plans under the relevant assessments. My patient says this arrangement helps him clearly describe his concerns, and he no longer fears forgetting important questions. For me, it has dramatically shortened the visit duration and documentation, and I no longer dread seeing his name on my schedule.

Inform patients about delays

Our organization has borrowed a tactic from the travel industry to update our patients on appointment delays. This strategy has resulted in higher patient satisfaction.

The airlines use electronic communication boards to inform passengers if their flights are on time or late. We purchased dry erase boards and magnets to serve a similar purpose. The boards are highly visible in the waiting rooms of our community health centers. Our nursing staff lists the names of each provider on the dry erase board, writes the appointment time of the patient currently being seen, and uses magnets to indicate whether the provider is on time or behind schedule. The nurses update the board every 20 minutes and communicate with the front-desk staff so they can inform patients of delays as soon as they arrive at the clinic. Below is an example of one such board (shown at 11 a.m.).

Medical providerAppointment time of patient being seen nowOn timeDelayed 15 minutes to 30 minutesDelayed 30 minutes to 1 hourDelayed more than 1 hour
Willis11 a.m.X
Negash10:45 a.m.X
Gray9:45 a.m.X
Rivera10:15 a.m.X

We implemented this initiative in June 2014. Between April 2014 and June 2015, our patient satisfaction scores regarding how we communicate information about delays increased from a low of 68.9 (out of 100) to a peak of 74.9, with an overall average of 72.2. Our nursing staff also reported fewer complaints from frustrated patients. We have since made the white boards routine in our outpatient practices in an effort to improve patient experience.

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Practice Pearls presents readers' advice on practice operations and patient care, along with tips drawn from the literature. Submit a pearl (250 words or less) to FPM at fpmedit@aafp.org.

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