This is the second in a series of articles aimed at highlighting key areas practices should examine in an effort to improve practice performance. This month we focus on how effectively managing the appointment schedule can have a positive impact on both patient and practice satisfaction. 

It’s rare that an appointment schedule in a medical office survives a day without any changes. No-shows, cancellations and last-minute emergencies will always crop up and cause shifts and changes. But these changes don’t have to disrupt the flow of the office. Here are a few things to consider:

To double book or not to double book
Many practices experience no-shows and/or a high demand for appointments when the schedule is full. To address these situations, many practices will book multiple patients into a single slot. However, double booking will likely guarantee some bad patient experiences. If you have a double booking system in place right now, the California Medical Association (CMA) recommends you review that process.

One thing to consider before double booking is the patient’s “show” record. Double booking two patients with perfect “show” records in the same slot is likely to guarantee a long wait for one of them. But, it may be a reasonable strategy to consider double booking if your scheduling system can provide information on the patient’s track record of showing up on time. If you have information on the probability of the patient keeping the appointment, consider double booking a patient with a perfect “show” record with another that has a poor “show” record. Double booking without this kind of information will almost certainly create a traffic jam at the practice and at least one unhappy patient.

Taking charge of your appointment schedule
Oftentimes, there is no rhyme or reason to how patient appointments are scheduled. In an effort to meet patient demand, sometimes patients are simply crammed into an already busy schedule without considering the appointment type and/or the amount of time needed for the appointment. For example, new patient visits generally require about twice as much time as an established patient visit, while follow-up appointments are typically the shortest.

If your practice doesn’t have a schedule template, create one by identifying the amount of time required for each different type of appointment. Working with the physician(s), determine the average amount of time the physician needs for new patient visits, established patient visits, follow-up visits, well care visits, etc. Build that information into your scheduling system so when you are creating an appointment, the amount of time is automatically calculated based on the type/need.

More in-depth triage
Beyond the schedule template, it can also be helpful for schedulers to do a more in-depth triage with patients to identify whether additional time will be needed. For example, an established patient visit to address multiple complaints will likely require more time than the average established patient visit. Training your office staff who are responsible for scheduling to ask specific questions such as, “Do you have any other issues to discuss with the doctor?” as well as encouraging patients to be on time (or even early) in order to prepare them to see the doctor will help to keep your practice running on schedule.

Pad the appointment time
Practices often make the mistake of advising patients to arrive at the time of their scheduled appointment. However, if the patient’s appointment is at 8 a.m. and he or she arrives at 8 a.m., after check-in at the front desk, completion of any necessary paperwork and rooming of the patient, it would be impossible for the physician to actually see the patient at 8 a.m. and therefore immediately puts the physician behind schedule. Imagine how far behind the physician will be if that patient is late to their 8 a.m. appointment!

While some practices report they advise patients to arrive 10-15 minutes early, let’s face it, most patients don’t comply. They remember their appointment time and rarely arrive any earlier.

One way to address this is to pad the appointment time by 10 minutes or so. For example, if the patient’s appointment is at 8 a.m., the practice may wish to advise the patient that the appointment is at 7:50 a.m. This allows time for check-in, paperwork and rooming so the patient is ready to see the physician at his or her scheduled appointment time of 8 a.m., which maximizes valuable physician time.

Following some simple, but well thought-out scheduling strategies can maximize the number of visits in a day, prevent a chaotic work environment and improve patient satisfaction.