How many times do you walk down the hall and see empty exam rooms or alternatively, how often are they filled but you still have patients waiting to be roomed and the doctors are running behind?
If nothing is going on in the exam rooms there is a financial cost to the practice; whether the room is empty or is occupied by a patient that is kept waiting. Ideally, if you have three rooms for each provider, this results in the physician in one room, the nurse rooming another or giving post visit patient instructions and a third room in transition by patient getting undressed or dressed and nurse preparing room for the next patient. It takes efficient and consistent facilities and processes, and optimizing the clinical staff’s time to make this happen. Depending on the specialty it may also require additional triage space or diagnostic space for pre-visit care such as cast removal, x-ray or blood work.
The first step to finding out how efficient you are with your exam rooms requires taking a critical look of the use and function of space and human resources.
Most EMRs now have the capability to track a patient through their visit from the time of check-in, when roomed and when the provider enters and leaves the room and when the patient is checked out. Use this information to analyze the variables and establish reasonable standards for the patient flow process that addresses how much time is needed for:
- Rooming a patient and preparing them for the visit;
- Clinical time each provider needs to spend with the patient; and
- Post-visit instructions and documentation
Going through this assessment offers the practice an opportunity to identify which processes are efficient and standardized, and which ones have little or no value and can be eliminated or automated. It also allows you to explore how well you are using your resources and how to optimize them. For example, do you have the nurses doing everything their skill level permits to support the provider and is the provider consistently delegating processes to the staff that don’t require his or her expertise? Of course staff must have the tools to optimize patient flow, such as scales in each exam room and efficient processes for taking vitals and recording them in the patient record, and ensuring all rooms are well-stocked.
Training clinical staff well and the providers efficient delegation of tasks to support staff often leads to physicians being able to stay on time and see more patients per day, as long as you predict and provide adequate exam rooms to manage the demand for appointments. And if you don’t, you can expand clinical hours by starting earlier, alternating lunches and using the otherwise unoccupied space during lunch breaks or offering evening hours.
Maximize you resources by refining processes to improve efficiency, exploring technology aides and optimizing both space and physician time. This is a win-win-win opportunity: improve access, workflow and profitability.
I’ve presented a webinar on this subject for many organizations — get in touch if you think yours might find it valuable.
Workflow analysis is also one of our specialties at Capko & Morgan. If you need help evaluating efficiency and exploring opportunities to make your practice the best it can be, contact us.
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