8 Ways to Improve Medical Practice Efficiency
Physicians in private practice sometimes face a plateau in revenue, or worse, declining collections. However, cost cutting and control of overheads is not the only way to maintain or increase income. Here are 8 ways to improve medical practice efficiency:
- Delegation
If the physicians at your practice are doing work such as patient education or data collection, this is an unproductive use of their time. It is far more efficient to delegate such tasks to physician assistants and trained administrative staff. Not only will the work be completed faster, it will leave doctors free to care for patients.
Delegation and dumping are two different things, however. Dumping the work means asking an untrained individual to do something and walking away. Delegating the work involves picking the right person to do the job, ensuring that the job is understood, and following up to give feedback. This ensures continuous improvement in staff performance and both physician and patient satisfaction. For example, during a visit discuss with a patient routine lab testing and tell them to expect a call from the clinic when the results are back. If the results are abnormal and require follow-up, then a call from the physician is warranted. However, if the results are normal, the task can be delegated to a nurse.
- Processes
Another way of improving practice efficiency is to have processes in place. For example, if the front office staff decides on a case-by-case basis when patients can be seen, this is an inefficient process that will disrupt the workflow in the practice. Doctors often ask receptionists to work a patient in. Adding a patient to an already full schedule is a disorganized way of conducting business.
Ensure that there is a process in place to deal with last minute appointments. The front desk should not be pressured into adding patients in. They should simply follow instructions, i.e., note down the patient’s information and offer the next available appointment. Patients in need of immediate care should be directed to the emergency room. Similarly, a process should be in place to filter phone calls. Physicians should not be bothered with unnecessary telephone conversations, but a patient whose health is in danger should be allowed to speak to a doctor. Processes help ensure the day-to-day functioning of the practice is not compromised.
- Communication
Written communication is more reliable than verbal communication. Slips, tickets, and order forms all improve efficiency and ensure that any instructions do not slip through the cracks. Written communication also helps save time. Lights outside an office are another example of nonverbal communication. A simple flick of a switch can indicate to the physician’s assistant that the visit is over. The physician can then leave the room to see the next patient as the assistant enters the exam room. Task lists in the electronic health record help make communication more efficient. For example, a superbill, slip, or ticket could tell your assistant to send off some lab tests and your receptionist to make the next appointment after a specified period of time. The physician saves time by simply adding the number of days, weeks, or months in front of next appointment on the task list.
Written communication takes care of another common problem in busy medical offices. Physicians never have to hear the excuse, “You never told me to do that,” again. When all instructions are documented, there is no confusion and the practice runs more efficiently. What’s important, however, is to avoid repetition. The patient’s EHR contains a wealth of information and rewriting it is a waste of time. Ensure that you’re not writing or entering the same information more than once. For example, you could create patient information handouts with unique titles, such as dietary restrictions. Your notes then simply have to state dietary restrictions handout given, without repeating all the information in the handout for each patient.
- Automation
Computers work faster and more efficiently than humans and make fewer errors in a number of tasks. Employee timekeeping is a good example of a process that can be automated for greater efficiency. Before purchasing new equipment, make sure your staff will be able to use it with minimal training and that it will be a good investment for your practice. Photocopiers that can collate and staple documents may save valuable staff time. The cost of the machine should be justified, however. Calculate the time spent by staff members in copying and collating documents and multiply it by the hourly rate. This will tell you in how much time the new machine will pay for itself. On the other hand, if big print jobs are rare at your practice, it might make more sense to outsource them to a print shop.
Picking the right vendor to purchase automation equipment is a critical step in improving efficiency. Make your requirements clear and ensure the vendor understands your needs. Ask about the cost of upgrades, should the workload at your practice increase in the future. Weigh the pros and cons of buying brand new equipment versus refurbished equipment versus renting. If the purchase is a big one, visit a conference or exhibition to become educated about the latest technology. Get your office manager to join local business organizations where managers often share their experiences.
- Time Management
Workflow efficiency is vital to the overall productivity of your practice. For example, new patients should receive the registration/demographic form and health history questionnaire as soon as they arrive for a visit. This will ensure that when the physician walks into the exam room, no time is wasted while the patient fills out a lengthy form. When the doctor is face-to-face with the patient, he or she can quickly go over the forms and gather any missing information. Written task lists can tell the assistant what needs to be done (for example, missing immunizations updated).
A good procedure is to tell patients to arrive at 10:45 for an 11 a.m. appointment. The extra 15 minutes can be used to complete paperwork and ensure the doctor’s appointment schedule runs smoothly. Avoid telling patients to come early. Patients rarely follow such an instruction. Rather, just tell them to be there at 10:45 when you put them down for an appointment at 11.
- Elimination
Eliminating inefficient processes at your practice is as important as adding efficient ones. For example, if staff members are routinely answering phone calls about confusions in billing, this is a waste of time. Make sure the billing functions are efficient and patients receive clear statements. If someone is filing unnecessary or irrelevant information, this not only clutters the patient’s medical record but is a waste of valuable time. Analyze everything that is being done at your practice simply because “we’ve always done it like this.”
A good way to identify inefficiencies is to ask every member of your practice staff to complete a task list. This will give you an overview of how each person is spending their time on the job. It will also point out whether three people are doing one person’s job or one person is overloaded with certain tasks.
- Quality Care
Don’t rely on staff memory to ensure quality care for your patients. Instead, use files, checklists, printed forms, and calendars for reminders. For example, if a patient’s lab results need to be followed up, put a copy of the lab slip in the file for the day the results are due. This will serve as a reminder to follow up on the results without the need to re-enter patient information and the follow-up required. Practices with in-house laboratories, however, must maintain detailed logs to comply with regulations.
Other ways of ensuring quality care are to balance daily deposits and receipts in the computer and enter the date of dictation. This ensures there is no unacceptable delay in staff members collecting and depositing checks or the transcription service returning dictation. Such processes keep a track of jobs that need to be routinely completed at the practice. Even if you don’t have time to look at the reports every time, it keeps everyone on their toes and gives you the confidence that things are being done efficiently.
- Supervision
A great way to improve efficiency is to use the work a person does to supervise them. For example, if you have an in-house transcriptionist, ask that their inbox is empty at the end of the day. This will automatically ensure that the day’s work has been completed. If someone is responsible for restocking cabinets, put a rubber band around the last two items. Removing the rubber band is a good reminder that the item needs to be restocked. Such processes obviate the need for constant supervision and ensure staff members are doing their jobs in a timely manner.
Use ticker files for items that are on back order. Delegate the task of following up with the vendor to the appropriate member of your staff. That person is then responsible for ensuring the items are received or current supplies are conserved if the item remains unavailable. These seemingly small measures are vital in improving efficiency and keeping things running smoothly at your medical practice. And once you improve productivity, your bottom line will surely reflect the changes you have made.
