1. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Chapter 13 Patient Scheduling

2. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Scheduling and the TPMS

3. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Tailoring the Scheduling System Customize system to accommodate the practice Primary goals –Smooth flow of patients with a minimal amount of waiting time –Flexibility to accommodate acutely ill, stat appointments, walk-ins, cancellations, no-shows

4. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Scheduling Styles May be done electronically or manually Will need to be HIPAA compliant Open hours –May use sign-in sheet –Patients seen on first-come, first-served basis –Common for emergency rooms and some clinics

5. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Patient Sign-In Sheet

6. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Scheduling Styles Double booking –Two or more patients are given a particular appointment time –Used in practices where more than one patient can be attended to at the same time –Patients should not have to continually wait for staff to attend them

7. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Scheduling Styles Clustering –Patients with similar problems are booked consecutively –Common for obstetricians and pediatricians

8. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Scheduling Styles Wave Scheduling –Patients are scheduled in first half hour of each hour –Requires personnel who can screen patients’ problems precisely when establishing appointments

9. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Scheduling Styles Modified Wave Scheduling –Two or three patients are scheduled at the beginning of each hour, followed by single appointments –There are a number of variations –Empty periods can be used for paperwork

10. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Scheduling Styles Stream Scheduling –Best known and most widely used –Each patient is assigned a specific time –Need to establish time guidelines for particular types of appointments

11. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Scheduling Styles Practice-based scheduling –Customized systems to fit needs of medical office –The practice determines the schedules –Appointment scheduling can be accomplished online

12. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Analyzing Patient Flow Patient flow analysis –Determines if office personnel are being used efficiently –Will help estimate the number of patients to schedule –Sets realistic time frames for procedures

13. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Analyzing Patient Flow Patient flow analysis –May need to build in slack time –Electronic scheduling systems easily analyze patient scheduling –Typical scheduling times for internal medicine practice

14. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Analyzing Patient Flow Waiting time –Offer patients explanation for delays and estimate the length of their wait –Never ignore the delay –Attempt to keep patients comfortable

15. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Analyzing Patient Flow Waiting time –Call patient to reschedule if delay is anticipated –Provide options if delay will be a half hour or longer –Act professionally

16. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Legal Issues Appointment schedules are legal documents Permanent records must be maintained A typed daily appointment sheet or computer-generated schedule is the permanent legal record of appointments Appointment scheduling should be accurate and consistently documented

17. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Interpersonal Skills Convey that patients are your priority, even in online scheduling Never let the patient feel ignored

18. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Guidelines for Scheduling Appointments Variables –Urgency of need of appointment –Whether appointment has referral from another provider –Recording methods for new and for established patients

19. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Guidelines for Scheduling Appointments Variables –Implementation of check-in, cancellation, and rescheduling policies –Use of reminder systems –Accommodating visits from medical supply and pharmaceutical company representatives –Group scheduling may be appropriate

20. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Guidelines for Scheduling Appointments Screening calls –Assess emergency calls before scheduling them –Ask appropriate questions –Do your best to address the situation

21. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Guidelines for Scheduling Appointments Referral appointments –Give special consideration and schedule appointment as soon as possible –Request patient’s records from referring provider before scheduling if patient calls for appointment

22. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Guidelines for Scheduling Appointments Recording information –Patients may be sensitive about giving information –List of items to obtain from new patient –Health history may be completed online prior to appointment

23. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Guidelines for Scheduling Appointments Recording information –List of items to obtain from an established patient –Provide choice of appointment times if available, perhaps evenings or weekend –Confirm appointment –Scheduling convenient time for patient may be difficult

24. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Guidelines for Scheduling Appointments Appointment matrix –Gives current, accurate record of appointment times available –Identifies doctor’s schedules, vacations, holidays, hospital rounds, meetings

25. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Guidelines for Scheduling Appointments Electronic scheduling –Computer searches database for available appointment time –Confirm time and date with patient –Enter patient data to automatically schedule appointment

26. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Guidelines for Scheduling Appointments Patient check-in –Record of patient’s appointments serves a legal purpose –Simplifies tracking of patient’s arrival –Patients must not see names of other patients

27. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Guidelines for Scheduling Appointments Patient check-in –Patients may refuse to sign check-in list –Might be better to check off patients’ names upon arrival –Electronic scheduling provides easy check off system when patient arrives

28. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Guidelines for Scheduling Appointments Patient cancellation and appointment changes –Indicate no-shows with a red X –Indicate cancellations with a single red line –Note no-shows and cancellations on patients’ charts

29. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Guidelines for Scheduling Appointments Click Here to play the video

30. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Guidelines for Scheduling Appointments Patient cancellation and appointment changes –Multiple no-shows or cancellations must be reviewed by provider Patient may not be committed to treatment Providers may decide to terminate services by sending certified letter to patient

31. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Guidelines for Scheduling Appointments Patient cancellation and appointment changes –Computer cancellations –Maintain list of cancelled appointments –Reschedule if appropriate >>

32. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Guidelines for Scheduling Appointments Reminder systems –Result in higher rate of fulfilled appointments –Methods Appointment cards Telephone call Mail Email

33. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Guidelines for Scheduling Appointments Scheduling pharmaceutical representatives –Can be important to meet with pharmaceutical and medical supply company representatives; sometimes monthly or at appointed time –Determine time allowed

34. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Scheduling Software and Materials Choice should make scheduling run smoothly Should be customized to medical setting Increasingly, all appointment scheduling is done electronically

35. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Scheduling Software and Materials Appointment schedule possibilities –Single page, single date –Week-at-a-glance –Multi-provider –Provides legal record –Quality management

36. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Scheduling Software and Materials Appointment schedule possibilities –Indicates arrivals, no-shows, cancellations, walk-ins –Includes patient appointments, provider’s meetings, and visits from salespersons –Helpful in scheduling work-in and emergency appointments –Can be transferred to a handheld computer for the provider’s immediate reference

37. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Scheduling Software and Materials Computer software and hardware –May schedule resources, equipment, examination rooms, specialty staff as well as patients and providers –Quickly locates next available appointment –May be a component of a total practice management system –Easy to access patient information –Online systems (securely encrypted) can handle prescription refills, email, and laboratory results

38. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Inpatient and Outpatient Admissions Appointments for outpatient or inpatient procedures most often made while patient is in facility Appointments might include: –Endoscopy exams –Specialized radiology procedures –Surgeries

39. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Inpatient and Outpatient Admissions Have a calendar available for the patient Necessary information includes: –Name, address, and telephone number of patient –Name of referring provider –Details of patient’s insurance, ID number, and Social Security number –Urgency of appointment

40. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Inpatient and Outpatient Admissions Make certain patient gets essential information (in writing) such as: –Date, time, and place of appointment –Any pre-examination procedures; any that might make travel difficult –Whether transportation will be necessary after procedure –When results of any procedure will be known

41. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Inpatient and Outpatient Admissions Hospital admissions –Use the same procedure –If hospitalization is immediate, determine if patient can return home for personal items and make other arrangements as necessary –May also be completed with a surgery scheduler –Scheduling surgery or specialty examinations is stressful; accommodate the patients as much as possible and be sensitive to their needs