Focusing on efficiency pays off for clinic
Patient load increased, overtime was eliminated
By getting the staff to concentrate on efficiency, Platte Medical Clinic in Platte City, MO, was able to increase the number of patients treated without increasing staff, eliminate overtime, and save paperwork for the administrative staff, who in turn could concentrate on collecting payments.
To cut expenses, the staff formed a group to look at internal processes such as overtime pay, staffing issues, and workflow processing. "We didn’t cut staff because that would have been viewed negatively and hurt the buy-in. Instead, we concentrated on eliminating redundancies and doing things more efficiently, says Lori Norris, FACMPE, physician recruiting and marketing director for North Kansas City (MO) Hospital, formerly practice manager for Platte Medical Clinic.
Here are some of the performance improvement projects the clinic implemented:
• Tracking lost revenue. The practice implemented a system to make sure that everything got recorded on the charge ticket. For instance, sometimes if a nurse gave an immunization it might not get recorded. The same was true with EKGs and X-rays.
The practice used a cross-check system. The nurses were instructed to mark down a procedure before it was done. The physicians were told to make sure everything ordered was included before they signed the fee slip. The staff did spot checks by random chart reviews.
Each EKG and X-ray was assigned a number. To get the number, the nurse had to log them in. The fee slips were compared to the log.
• Increasing patient loads. Each physician and each nurse practitioner were given a goal as to how many patients they needed to see each day and asked for their input. The staff tracked the patient load each day to see how it was working.
If the physicians weren’t meeting their goal for the number of patients they saw each day, Norris looked for the reason. If there were no-shows, the staff looked at double-booking and using a patient-reminder system. The front desk had information on how many patients each physician agreed to see each day.
"If the physicians complained about the front desk working patients in, the staff reminded them that they agreed to see a certain number of patients a day, which gave them room to add additional patients to the caseload," Norris says.
Instead of holding Saturday open for emergency appointments, the staff decided to book 10 appointments. Staff members were assigned to give reports on how the practice was working.
• Coding. The staff conducted a coding review and coding education for physicians, showing where they were documenting but not giving themselves enough credit. (For more about coding reviews, see articles, p. 53 and p. 54.)
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