Y khoa - Dược - Chapter 16: Schedule management

16Schedule ManagementLearning Outcomes (cont.)16.1 Describe how the appointment book is key to the continuity of patient care.16.2 Identify how to properly apply a matrix to an appointment book.16.3 Compare different types of appointment scheduling systems.16.4 Identify ways to organize and schedule patient appointments.Learning Outcomes (cont.)16.5 Model how to handle special scheduling situations.16.6 Explain how to schedule appointments that are outside the medical office.16.7 Implement ways to keep an accurate and efficient physician schedule.IntroductionScheduling systemsTypes How each is usedScheduling situationsAppointment bookLegal aspectsDocumentationThe Appointment BookA well-managed appointment bookCreates an efficient patient flow Shows respect for  everyone’s time Unexpected events that occurEarly and late arrivals Emergencies Patient’s who require extra timeComputerized SchedulingLock-out featureAccessIdentification of problem patients“Search” featureReports featureColor-coding featureScreen captures of SpringCharts™ Electronic Health Records software are reprinted with permission from Spring Medical Systems, Inc. All rights reserved.Online SchedulingNot for all office typesCost and security have been barriers Prior to purchasing an e-schedulerAssess practice needsDetermine potential for useResearch products Apply Your KnowledgeWhat advantages does a computerized scheduler have over a paper appointment book related to continuity of care?ANSWER: It enables you to identify possible noncompliant patients who cancel appointments, often arrive late, or are no-shows It enables you to search for upcoming appointments to ensure follow-up care is given.It allows for access from multiple areas so a physician could check for a patient in an examination room.Good Answer!Applying the MatrixBlock off times the doctor is unavailable to see patientsSchedule around those timesUnblock appointments if physician becomes availableRequired Patient InformationObtain patient informationPatient’s full nameHome and work telephone numbersPurpose of the visitUse only approved abbreviationsStandard Appointment TimesCreate a list Standard appointment timesTime needed for common testsThis helps in choosing an appropriate appointment book or schedulerThe Appointment Book as a Legal RecordKeep appointment books 3 yearsEntries – clear and easy to readCorrections or changesDraw a single line through the entryAdd appropriate commentInitial the entryDocument in medical recordUse your knowledge of abbreviations and scheduling to order these from least time required to most time required. (1= least time required and 5= most time required)Apply Your KnowledgeS/RCPEf/uCANP&Psuture removal 10–20 min.35214complete physical examination 30/60 min.follow-up appointment 5–15 min.cancellation 0 min.Pelvic examination and Pap Smear 15–30 min.ANSWER:Appointment Scheduling SystemsGoalsSmooth flow of patientsMinimal wait timeOpen-hours schedulingNo appointmentsEmergency room, urgent care centers and some rural practicesAppointment Scheduling Systems (cont.)Time-Specified SchedulingStream schedulingPatients are scheduled for specific timesRegular intervalsAmount of time – based on the reason for the appointmentAppointment Scheduling Systems (cont.)Wave SchedulingFlexibility to allow forPatients who arrive latePatients who require more or less timeUses an hourly target number of patientsArrive at the same timeSeen in order of arrivalAppointment Scheduling Systems (cont.)Modified-wave schedulingPatients scheduled in 15-minute increments Four patients scheduled during the first half hour and the second half hour is left free for catch-upDouble-booking systemTwo or more patients scheduled for the same time Used when patient with no appointment needs to be seenAppointment Scheduling Systems (cont.)Cluster scheduling Groups similar appointmentsUseful if specialized equipment has limited availabilityAdvance schedulingScheduling weeks or months in advanceLeave a few slots open for unexpected needsCombination scheduling – using two scheduling methodsApply Your KnowledgeA large pediatrician office commonly must “squeeze in” patients in that have become ill. The practice also plans to begin offering immunizations only two days a week. Which scheduling system(s) would you recommend for this medical practice?ANSWER: Combination scheduling system consisting of cluster scheduling for the immunizations and wave or modified-wave scheduling to allow for the needed flexibility of emergency patients.Right!Organizing and Scheduling AppointmentsBe professionalAccommodate patient’s needs if possibleTime neededPatient statusChief complaintNew PatientsThose not established at the medical officeObtain all necessary informationContact informationInsurance informationCo-pay informationNew patient formsEstablished PatientsCurrently seen by the practiceReturn appointmentsMake as patient is leaving officeSet patternAppointment reminder cardAppointment Confirmations and RemindersAppointment cardsEnter appointment in scheduler Fill out cardDo not rely on memory to enter appointment into book or schedulerAppointment Confirmations and Reminders (cont.)Encounter forms/superbills Receipt for paymentInformation about next appointmentReminder mailingsPostcard with time and date of appointmentPut in tickler file on date it should be mailed Appointment Confirmations and Reminders (cont.)Confirmation Calls To confirm a scheduled appointmentUseful for frequent late arrivals or no-showsRecall notices – reminder to call for an appointmentE-mail notificationsPatients enroll and receive a passwordNotifications of up-coming appointment sentApply Your KnowledgeThe doctor wants Mr. Lincoln to return to the office for a follow-up appointment in two weeks. What should the medical assistant do?ANSWER: Offer Mr. Lincoln a choice of dates and times available. After entering the appointment in the book or into the computer, confirm the date and time with the patient and give him a appointment card.Special Scheduling SituationsEmergenciesSeen immediately upon arrival at the officeExplain situation to waiting patientsReferralsSee referred patients as soon as possibleWhen arranging referrals Provide choicesBe sure the facility accepts the patient’s insuranceDocument in patient recordSpecial Scheduling Situations (cont.)Fasting patientsSchedule as early as possible in the dayInstruct patient about the need to fast and when to startPatients with diabetesRequire regular meals and snacks Avoid late morning slotsLate arrivalsSchedule chronically late patients toward the end of the dayDocument late arrivals or missed appointmentsin patient recordSpecial Scheduling Situations (cont.)Walk-insIf it is an emergency, handle as suchIf no openings, offer to schedule an appointmentPost a sign in the office if no walk-ins are allowedSpecial Scheduling Situations (cont.)CancellationsThank patient for calling to cancelMark appointment as canceledAttempt to reschedule Document cancellation in the medical record J. Jones 123-456-7890cancelledS Smith 098-765-4321R Hansen 456-789-0123M Fitz 321-456-0987Special Scheduling Situations (cont.)Special Scheduling Situations (cont.)Missed appointments Document in the appointment book Document in medical recordInform the physician of no-showsCall or send polite reminderWrong dayRescheduleAttempt to accommodate ifPatient came a long distanceMade special travel arrangementsPhysician Scheduling SituationsPhysicians may throw the schedule off byArriving late to the officeBeing called away for emergenciesBeing delayed at the hospitalIf a physician is repeatedly late, you may want to add some buffer time to the schedule.Apply Your Knowledge Mr. Washington needs a follow-up appointment in a week for a fasting lab tests. How should you handle this appointment?ANSWER: The appointment should be made for the first or second appointment for that day. Mr. Washington should be reminded he should not eat or drink after midnight.SUPER!Scheduling Outside AppointmentsVerify insurance coverageObtain referral or approval if neededMake appointmentInstruct patient Document in medical recordReserving an Operating RoomCall OR scheduler to reserve spacePreferred date and timeType of surgeryRelevant patient informationInsurance requirementsPatient instructionsApply Your KnowledgeWhat is the first thing you should do before scheduling an appointment for a referral to a specialty physician? ANSWER: The first thing you need to do is to verify that the physician will be covered by the patient’s insurance.Very Good!Maintaining the Physician’s ScheduleMaintain a BalanceVisits Outside the OfficeHouse calls – check on home-boundHospital roundsNursing home visits“Mouse calls”Scheduling Pharmaceutical Sales RepresentativesPhysician preferenceScheduled block of timeBy appointment New representatives Request a business card Check with the physician before scheduling an appointmentMaking Travel ArrangementsTravel and lodging arrangementsItinerary – several copies for physician and one for the officeA locum tenens or substitute physician may cover practice while regular physician is awayPlanning MeetingsFind out number of people, length and purpose of meetingSecure location with adequate room, parking, and food servicesSecure AV equipmentSend invitationsCreate agendaPrepare minutesScheduling Time with the PhysicianIrregularities or changes in the scheduleOther items for discussionPractice finance Taxes and other financial mattersProfessional licenses Renewal requirements for the medical staffApply Your KnowledgeWhy is it important to maintain a balance in the physician’s schedule?ANSWER: To help the physicians use their time efficiently.Right!In Summary16.1 The appointment book or electronic scheduler and its matrix, when used properly, allow the office staff to respect the time of both the physician and patient, by keeping an efficient and timely flow of patients throughout the day.In Summary (cont.)16.2 To create a matrix you must know the usual schedule of physician availability to see patients as well as the times the physician (or practice) will not be open to see patients. The latter times should be X’d out with a short reason given as to why the time is unavailable. Follow the instructions for the electronic scheduler to block out the appropriate time frames.In Summary (cont.)16.3 The most commonly used types of scheduling systems are open-hours, time- specified, wave, modified wave, double booking, cluster, and advance scheduling. It is also common for offices to use any combination of the above as best suits each practice.In Summary (cont.)16.4 When organizing and scheduling patient appointments, always maintain a positive, professional image. The patient’s status should be considered as well as patient preference. The goal is to accommodate the patient, while still maintaining an efficient schedule. Appointments should be confirmed through appointment cards, phone calls, email notification and mailing recall notices.In Summary (cont.)16.5 Handling special scheduling situations requires critical thinking skills and creativity. Scheduling situations can arise if the physician is running late or if a patient requires an emergency appointment. Other scheduling problems may also include a patient who does not show, arrives late, or arrives on the wrong day. Document any patient-related appointment issues the patient’s medical record for legal purposes.In Summary (cont.)16.6 In order to schedule outside appointments you will require the patient’s demographic and health insurance information along with the procedure or service to be performed and the reason for the service. Preferred dates and times should also be noted. If referrals or prior authorizations are required, you may also be required to obtain these.Taking a few extra minutes, going that extra mile, and giving that added special touch can make a world of difference in a very difficult situation.~ Lisa Lockhart(From A Daybook for Nurses: Making a Difference Each Day)End of Chapter 16