Analyze patient flow to solve scheduling woes
Methods help you identify the bottlenecks
A patient flow analysis can track the experiences of both patients and providers and give an overview of what is happening during clinic hours, says Julie Elmore Jones, MBA, MHA, a consultant with Gates, Moore & Co., an Atlanta-based health care consulting firm.
The process can give you internal management information such as staff mix and utilization, an analysis of your appointment scheduling methods, and problem areas or glitches in the way patients move through the system.
"It’s a relatively easy thing to do, and it gives you a wealth of great information," Jones says.
Here’s how a patient flow analysis works:
Each staff member who comes in contact with patients fills out a personnel registration form that includes his or her job and an assigned code number. Staff members log in when they begin seeing patients and log out when they take a break. This tracks each staff member’s actual time on the job.
A patient registration form is attached to the medical chart and follows the patient through the visit. Every time staff who work in the practice come in contact with the patient, even if it’s for 10 seconds, they enter their code and log in the time their face-to-face contact starts and ends. For instance, if the medical assistant calls a patient in, takes the history, weighs the patient, and sends the patient to the lab, the assistant logs his or her time in and time out with the patient.
The person who is the primary caregiver for the patient, in most cases the physician, initials the form, records the time in and time out, and includes the reason for the visit.
Once the study is complete, Jones checks the data for accuracy, then enters them in a computer program that analyzes the schedule and pinpoints bottlenecks.
"Often, practice managers and administrators already have a sense of what the problem is. When you get statistical tables and graphical representations of where the problems are occurring, you see not only what is happening to the patients but what is happening to the physician," Jones says.
The studies give you the tools to determine where the bottlenecks are occurring and how to eliminate them.
For instance, if it appears the well-patient visits are taking too long, you could find that there is a backup in the lab or that the examinations were not scheduled appropriately for the physician who was doing them that day.
"Some physicians work more quickly than others. Some practices schedule 20-minute appointments regardless of who is doing them. The patient flow analysis can point out these problems and help you schedule for maximum efficiency," Jones says.
While you can do a patient flow analysis yourself, Jones recommends using a consultant or external advisor to give a fresh perspective to the problems and issues in your practice. "Much of the survey deals with observations and interviews with the physicians and key staff. Often, people who work every day in a practice have difficulty seeing that things could be done differently. It’s the same with all of us," she says.
If you decide to conduct the analysis in-house, choose the practice manager or someone else who does not normally come in contact with the patients, Jones advises. "If you come in contact with patients, you are part of the study. You can’t be in the study and implement it."
The purpose of a patient flow analysis is to see what happens under normal circumstances. If one person is removed from the normal process, you can’t get a good sense of what is happening, she adds.
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