Four ways to protect your practice's schedule against emergencies

Judy BeeThere are many ways a doctor’s schedule can get derailed - an expecting mother is ready to deliver her baby, a patient in respiratory distress needs immediate attention, or there is an influx of patients with influenza requesting to see a doctor. Do you have a scheduling disaster plan?

Practices that make an effort to learn from their own schedule experiences do a much better job of booking appointments that reflect reality. Here are four ways to help your practice keep its schedule on track. Will these tactics make every day run smoothly? No. Remember, your service will not improve if you don’t take a realistic approach to scheduling.

Calculate the doctor’s rate

A doctor who says she wants to see four patients an hour, but who can only see three per hour, will be an hour behind schedule by noon. Time the doctor from the first scheduled appointment start time until she’s finished with the last patient, and divide the time by the number of patients.

Do this every day, and keep a record to determine the average number of patients you can reasonably count on treating.              

Track work-ins

Each day, have the check-in person tally and record the number of patients scheduled before the day starts, the number of patients that actually show up, the number of patient appointments scheduled the same day as work-ins, and the number of patients rescheduled by the practice due to an emergency that takes the physician out of the office.  Do this every day so that you have some facts (and not just the doctor’s optimism) to work with.

Build a schedule disaster plan

For example, at an OB/GYN practice where the solo physician did all her own deliveries, the data showed she was called out of the office about 1.5 times per week.

That inconvenienced the 10 patients who were scheduled simultaneously with the delivery and impacted her schedule for the rest of the day. She was scheduled so tight into the future that there was no space available to move patients that preferred to reschedule.

The solution: Save Thursday afternoon for “open” space to reschedule patients affected by the interruption.

Then if there are open Thursday time-slots by late Tuesday, then make them available for all patients.

Include in-office emergencies

Often there are patients who are too sick to wait until the next day to be seen-that’s an office emergency. If they can wait a couple of days, it’s an urgency. Your historical data will identify your busiest days-usually Monday and Friday.

Don’t schedule routine physicals or in-office procedures on Monday. Leave open spaces in the afternoon so  that you can offer same-day service.

Keep Fridays light. A patient who can wait a day on Friday could flare into an after-hours emergency over the weekend. If your history tells you Wednesdays and Thursdays are the lowest in same-day demand, load up your schedule with longer appointments those days.

Monitor your activity and note the number of same-day calls. Adjust open spaces daily based on no shows and cancellations. 

Judy Bee is a practice management consultant with Practice Performance Group in La Jolla, California and a Medical Economics editorial consultant. Send your practice management questions to medec@advanstar.com.

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