How to maximize patient scheduling and expedite long office waits

December 1, 2007
Stephanie Skernivitz

A system should be put in place to analyze patient flow in the office. Designing an optimized patient appointment schedule and solving some common patient flow problems can make a difference.

Key Points

One of the greatest-if not chief among-patient complaints is the actual time they have to wait before being seen by the physician, ophthalmologist, surgeon, or fill in the blank.

"Patient flow is a constant challenge. It's very complex and changes constantly," said Derek A. Preece, MBA, who presented on "New ways to increase patient flow and reduce wait times."

Preece, who has consulted for ophthalmology practices for 20 years, said practices should consider developing a system to analyze patient flow in their respective offices. He discussed how to design an optimized patient appointment schedule and offered suggestions for solving some common patient flow problems.

"Anybody see a problem here? How many patients can he schedule per hour, spend 10 minutes per patient and stay on time? At the end of the first hour, he had done six appointments and four were waiting. At the end of two hours, he had done 12 and eight were waiting. No wonder he worked through lunch," he said.

Yet Preece noted that remarkably nobody in the office, including the physician, had ever sat down to figure out how much time was really needed to see the patients.

What the basic patient flow issue boils down to is the fact that practices lack good data and careful analysis, according to Preece. "We simply don't know how long it takes our physicians to see a patient. Therefore, we schedule without regard to this critical factor," he said.

Often practices don't take into consideration that the time needed per exam will vary, depending on the type of exam. When each exam is scheduled for the same length of time, it's a train wreck waiting to happen, said Preece.

The following are key principles when devising patient flow strategies:

A physician time tracking sheet is recommended when beginning the patient flow process. One option is to hire a temp to time the physician for one day to gather the data prior to starting the analysis. Record on the tracking sheet each patient's name, exam type, and when the physician starts and ends each exam. Such data will give practices an indication of how much time is needed for each exam, especially if your practice offers several different types of exams.

In short, the data needed to carry out the analysis are: types of exams; what percentage are considered short, medium, or long exams; and time needed to schedule each exam. Step two is to analyze the data. Basically, you will multiply physician's exam time by its percentage of total number of exams to get the weighted average exam time. The end goal is to discover how long the physician is taking per exam to know how many exams to schedule in a given timeframe.

Because scheduling is usually done by the hour, determine how many short and long exams the physician is conducting per hour to build the appointment schedule. Determine the length of time per short exam (e.g., 4 minutes); medium exam (e.g., 8 minutes); and long exam (e.g., 12 minutes).