Patient access is a key driver in the efficient use of healthcare resources, patient satisfaction, provider engagement and profitability. Access to care is a large-scale concern for health systems at a time of rising consumerism and professional workforce shortages. And, access is foundational to achieving Quadruple Aim objectives for quality, experience, health and provider engagement.
How should a leadership team approach the complex issue of access?
An access audit will inform you of current appointment management performance and opportunities for improvement.
Through a variety of reports, patient feedback, and other practice information sources, an audit will answer several questions:
The patient scheduling system is a robust source of information. It can provide insights into the total number of available appointments, the distribution and the utilization of available appointments. Next, first and third available appointment reports reflect the timeliness and availability of appointments offered to patients.
An understanding of baseline cancellations and no-shows are other data points to incorporate in the analysis. If the appointment system lacks robust reporting capabilities, missed appointments can be tracked manually for a prescribed interval.
Another critical feedback source is patient experience data, which provides quantitative input on access and qualitative feedback through survey comments. Complaints received by clinic staff regarding access should also be tracked to understand the patient perspectives and to identify opportunities to improve. Through patient feedback, the impact of improvement efforts can be measured over time. Patient experience surveys also provide insights for better understanding patient needs and expectations. Each market, neighborhood and patient population has unique expectations of access.
A patient survey or focus group can provide your practice insights into how best to address their specific needs for access. Many customers appreciate extended hours, especially in the primary care setting. An increase in clinic hours should reflect the needs of the clinic’s patients. For some practices, patients desire early morning hours for routine care. In other markets, patients may prefer end-of-day routine appointments, walk-in care availability or weekend hours.
In addition to patient focus groups, here are strategies to identify patient population access needs:
- Engage your practice staff through dialogue and consistent feedback.
- Ask scheduling staff to maintain an access log to track the incoming patients as well as patients who are referred to an alternate care site due to lack of appointment availability.
- Analyze and act on no-shows. Engage the clinic team in understanding the patients who are likely be a no-show.
- Is transportation making it difficult for patients to keep their appointments?
- Is there one type of appointment resulting in no-shows? For example, in some specialty practices, are new patients scheduled for elective procedures more likely to not keep an appointment?
With an understanding of patient access needs and appointment monitoring, health systems can deploy strategies to minimize the impact of no-shows on the practice schedule and improve access to care.
A team commitment to patient-centered scheduling and common operating understanding between physicians, advanced providers, clinical, support and administrative staff is an essential factor in effective management of provider capacity. Baseline data, patient feedback, and physician and provider schedules must align with the patient need to determine access.
While every practice will have occasional staffing conflicts, it’s important to honor patient schedules to maintain patient confidence as healthcare provider of choice. If re-scheduling is necessary, give patients as much as notice as possible, or offer an alternate provider to see during their scheduled appointment time.
Baseline data is also instrumental in understanding peak demand times within your practice. If you do not utilize an open access schedule, you can still enhance access during peak times:
- Block appointments to allow for urgent needs.
- Avoid scheduling re-checks or routine visits during peak times.
- Ensure provider and support team staffing align with known peak demand periods.
Minimize the number of rules for scheduling. Make it as easy and efficient as possible for your staff to schedule patients. Typically, the more standards the scheduling team must navigate, the less efficient and patient-friendly the scheduling process. Both patients and staff will appreciate simple scheduling templates and standards.
Staffing, procedures, workflows, and technology can enable or impede patient scheduling. From a staffing perspective, who does most of the appointment scheduling? Preferably, dedicated staff is scheduling patients, whether dedicated staff within the clinic, a shared team of schedulers supporting several clinics, or a centralized call center with expanded hours.
Encourage patients to schedule appointments online and make the process simple. Most practices can accept an online patient request for an appointment. However, scheduling requests a series of asynchronous communications before an appointment time is secured. Standard appointment types are a more efficient on-line method, allowing patients to self-schedule in the appointment system. Online scheduling increases patient satisfaction and staff efficiency.
The telephone system in your practice is typically a rich source of information about your practice. Various reports provide insights into the customer experience and access. Dropped calls, length of calls, amount of time on hold are all factors in the experience of your patients as they try to make appointments. Utilize the data provided by the telephone system to make improvements to workflows and staffing. Technology offers an array of means by which to remind patients of upcoming appointments. Phone, text and portal messages all serve to minimize no-shows.
As technology continually evolves and increasingly plays a role in how patients manage their daily lives, providers must also utilize technology in their patient interactions. The patient portal provides many benefits with its capacity ease patient check-in, improve patient experience and increase cash collections:
- Provide an online patient portal for patients to complete paperwork and forms.
- Collect co-pays as part of the check-in to streamline workflows
Technology also makes it possible to improve access through e-visits. Offering video visits to diagnose straightforward and appropriate conditions can increase patient access, satisfaction, and loyalty. Operationally, e-visits allow clinic resources to remain focused on patients with more complex needs.
Additionally, electronic medical record platforms are developing more robust e-visit capabilities, which minimize patients going elsewhere for e-visits. Having e-visit documentation in the patient record provides a complete picture of the patient’s health and care.
Access creates the first impression of a practice. It sets the tone for the relationship between the patient and the practice. Would you like your healthcare organization to start implementing these tactics? You don’t have to do it alone. Discover how QHR can help. Our upcoming webinar, Physician Practice: Access to Care, could be a great resource in helping you improve patient access in your community.
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