Have you ever been a patient in a medical office that seems like nothing ran smoothly or efficiently? There were miscommunications, long wait times, scheduling conflicts, billing ‘surprises’... Everything just seemed “out of sorts”? I’ve been a patient in that office- I think we all have at some point or another and in varying degrees. I’ve even worked in that office and trust me; it isn’t any less frustrating on the other side. I’ve been working in medical offices since my time as an undergraduate in 2007. I’ve worked with many different specialties, in different types of practice settings, and with various types of providers. With my years of experience I’ve gained a lot of knowledge about how a good front office work flow and a bad front office work flow compare. I’ve worked in both types of environments and in some cases, helped to make improvements that positively impacted our day to day operation. There are a couple of key factors to consider when improving your front office work flow.
Keep communication open:
In one of my previous posts, I made the all too common statement that ‘knowledge is power’. Though this comment is use a lot and in many different contexts, it is still very true. Making sure that lines of communication are open not just between management and staff, but all levels of staff is important. Medical offices are busy places but making the time for weekly or monthly meetings can make a huge impact. I find that these meetings keep everyone on the same page about the agenda for the week, keeps the staff informed about happenings or events that maybe they do not have to deal with directly, and also opens the doors for comments, ideas, and questions about anything that might be going on or coming up for the office. I always felt more connected and more purposeful after a meeting because I was reminded that I am not just a cog in the wheel- I am a detrimental part of the operation. I’ve even worked in an office that held short “pow wows” or “huddles” every morning just to get everyone on the same page and prepped for the work day. This helped tremendously from a moral standpoint as well. We felt like a team and subsequently behaved like one. Having that sense of purpose can help all staff members to feel responsible for themselves and their job duties and accountable for their job performance.
Optimize your patient flow:
If you’re getting complaints from patients or having miscommunications between patients and staff there could be an issue with you patient flow; which is bad news. The good news is that patient flow issues can be resolved often times by making a small change. The first thing to do is take the time to walk through the process in the “shoes of the patient” or have a meeting with the staff to talk through your process out loud. During this time, inefficiencies may become apparent and your staff may already have ideas on how to fix them! Use you staff’s experience and their input wisely. They do the job and interact with the patients more than anyone else in the front office so their information and perspective is valuable! The case study below is an example of how a small change, that had no financial impact on the medical office, relieved a patient flow issue that was negatively impacting the patient experience and the moral of the office staff.
Case Study Example: Patient flow inefficiencies in the Neurology/Neurosurgery department at Mayo Clinic, Jacksonville.
Patient checks into the front desk at the neurology/neurosurgery department and is asked to sit in the lobby until they are called back for their appointment. From the time they are called back for their appointment by a Patient Service Specialist (PSS), a patient has many interactions with different office desk staff members, nurses or physician assistants, the providers and the scheduling and administrative teams. In one office visit a patient can see and interact with anywhere from 3 to 7 different people!
Patients felt as though they were “getting lost” in the process leaving them confused and with questions about the next step and/or not knowing who to direct their questions to. PSS and scheduling team members were also having trouble knowing who the patient interacted with and often times needed clarity on the orders that were placed for the patient they are working with. The secondary issue is that the department’s budget did not allow for a lot (if any) money to be spent on solving this issue.
Create a more cohesive patient flow without changing too much of the process for everyone involved or spending little or no money to make the change happen (try to use what resources they have).
Everyone hired at Mayo Clinic is given a stamp with their initials when they are hired as part of the onboarding procedure. This stamp follows you no matter what position you hold or what department you’re in during your time of employment at Mayo Clinic. My idea was to have each person who has contact with the patient stamp their initials in the order from the first interaction at the top of the page on down. This helps everyone to know who the patient interacted with during each stage of their visit and who to direct questions or patient concerns to.
Having each person working with the patient stamp their initials on the patient information card cut down on patient confusion because any member of the staff was able to look at the card and know who to direct the patient’s question to. This method also cut down on the office staff’s confusion because they knew who to go to for clarity on the patient’s orders. Should a question or complaint come back to the department long after the patient’s visit is completed, the card could be pulled and each person who interacted with the patient identified. Lastly, because the solution used a stamp that all employee have, NO money was spent on this solution.
Copay Collection and Insurance Reimbursement:
Asking people for money can be hard, but making sure your staff is prepared to collect at the time of service will make a world of difference. Training and open communication about what to say and how to say it is very important in medical collections. Also, make sure your staff is performing insurance verifications (or utilizing that feature of your EMR) and finding out what copay or patient responsibility amount is due at the time of service. Make sure also that they are communicating that amount to the patient prior to the appointment (if possible) in an effort to make the collection process run more smoothly. Lastly, having multiple payment options available is also important to your patients. Only taking cash or check is a thing of the past. Traditional credit card readers, chip readers and one touch payments are the most popular form of payment (generally speaking). Offering bill pay services on your patient portal or keeping a payment card on file for people knowing they need to have multiple appointments is also a convenient way for patients to pay their bill.
Documentation needs to be up to date:
All offices should have documentation of some kind of their processes. If you do not have any documentation, your employees might be feeling lost or confused. Getting your process out on paper can help to eliminate the confusion. If you do have your processes properly documented, take some time to review your office handbook, job descriptions, and standard operating procedures just to be sure they are current with how your office runs now. This is something that can so easily be forgotten about or overlooked, but is very important. Over time, things change in an office environment- most often job duties and procedures as we evolve and become more technologically dependent. Depending on the amount of change your office is going through, I recommend reviewing your office documentation and making applicable updates on at least an annual basis.
Make sure your technology is working with you and not against you:
Do you feel that your EMR is not user friendly or tedious, but aren’t financially or contractually able to make a change? Talk to your EMR administrator or support team about the issues you are having. There may be functions or features you can enable or disable that can increase productivity or make your job easier!
If you’re feeling the effects of an inefficient work flow and would like some help, please contact one of our consultants! For more information and industry updates, follow us on Facebook, Twitter and LinkedIn. We also have a monthly e-newsletter, click here to stay in touch!