Optimizing Patient Flow

By Toni J. Eberhardt, Vice President of Marketing and Client Operations for UniteRx

Patient flow through a practice from check-in to check-out may seem like an organic process, but, as astute practice administrators recognize, it is like conducting an orchestra; one person being “out of tune” can have a tremendous impact. Optimizing patient flow can increase patient satisfaction and improve practice efficiency. According to a study in the journal Health Affairs, patient-flow strategies can also be used to manage fluctuations in demand, reduce costs and boost revenue. 

An effective patient flow strategy ensures that practices operate at full capacity, physicians optimize time with patients, and time-wasting processes are minimized. ZocDoc identified five opportunities to optimize patient flow. Below, we have listed those opportunities and provided guidance as to how each can be applied to a dermatology practice. 

1. Physical access to the practice: Make it easy. 

From locating your practice to parking, understand your patients’ potential challenges. 

• If the practice is in a medical office complex, provide visual clues as to where the practice is located, i.e. “the back of the building on the side closest to Main Street.” 
• Is parking a challenge? If yes, request designated patient parking for your practice from the property manager; if that’s not possible, advise new patients to allow extra time to park or provide them with hints as to where parking spaces are generally available. 
• Coordinate with the property manager to have directional signs in the parking lot, building lobby, etc. so patients can easily find your practice. 
• Ensure that a “drop-off” area is available near the entrance for patients that have physical mobility limitations. 

2. Patient flow inside the practice: Direct traffic. 

Patient privacy goes beyond HIPAA. Minimize the instances of patients crossing paths by having separate check-in and check-out areas. Ensure the number of patients checking in does not become backed up by spacing appointments appropriately, having enough front office staff based on the number of providers and appointments daily and having appropriate signage and directions in the waiting area to educate patients on the check-in process. When patients cross paths, frustration and/or anxiety can increase, thereby decreasing efficiency and patient satisfaction. 

3. Optimize appointments for the patient: Prioritize appointments. 

When thinking about appointments, the natural thought is the length of different types of appointments, the number of appointments each provider can handle and how to manage both versus the number of available exam rooms. One way to optimize appointments for both the patient and the provider is through proactive review of appointments the day prior, especially for existing patients. As the provider 

and practice get to know patients, make notes to help optimize appointments; for example, does a patient require more time and information? Is there a patient consistently early or late? Is another patient one who is more efficient, allowing the appointment to generally take less than the allotted time? What is the reason for the appointment, and has the patient encountered this medical issue in the past? Prior day review of scheduled patients by the provider can enable slight adjustments or expectations to be set as patients arrive. 

4. Incorporate space and/or tools for provider documentation: Have a home base. 

According to the Annals of Family Medicine, providers are “tethered to the electronic health records (EHR)” and spend more than 50% of their day on EHR tasks; this phenomenon is not exclusive to primary care. Having a mobile tablet or setting up a workstation in the provider flow enables paperwork and documentation to be completed in a timely and efficient manner, mitigating the need for providers to go back to their offices to input information. 

5. Maintain forward flow: Identify bottlenecks. 

Shadow each participant in the patient flow, including the patient, provider, medical assistants and administrative staff to identify where the patient flow is interrupted or delayed. In doing so, opportunities to adjust the workflow can be surfaced, as well as opportunities to augment operations with services and/or solutions to decrease bottlenecks. 

For example, according to multiple studies, medical practices spend a significant amount of time on human resources managing pharmacy calls, faxes and pharmacy-initiated changes to patients’ formularies. In fact, one study found clinicians spend two hours weekly consulting with patients about medications and costs, nearly two hours working on prior authorization forms and an hour working to understand drug pricing for patients (Source: 2018 Impact Report: Prescription Price Transparency, from Surescripts). To address this bottleneck, some dermatology practices have implemented a “Prescription Help Desk,” enabling not only visibility to pharmacy benefits, but allowing the practice to dispense prescriptions to the patient at the point-of-care. By implementing an in-office dispensary, these practices have eliminated a bottleneck for the providers, staff and patients, resulting in cost savings for the practice, increased patient satisfaction, improved therapy adherence and increased revenue for the practice. 

As published in Executive Decisions in Dermatology, a publication by the Association of Dermatology Administrators and Managers (ADAM)