| Re-engineer Your Practice?Starting Today |
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Page 1 of 3 Improve access and efficiency, and your patients and staff
will have something to smile about. Here's how some medical offices are
doing it.Something amazing happened to FP Greg Long last February. That was when his four-doctor practice in Appleton, WI, began offering patients appointments the same day they called. Previously, they'd had to wait 10 to 14 days for a nonurgent appointment, and up to six months for a physical. Now, Long and his colleagues can see their patients when they want to be seen—and without working longer hours. "My job satisfaction has increased, because I know I'm giving my patients better service," says Long. "And I know they're happier, because they're telling me they are." The nurses are happier, too. "They don't have to sit on the phone trying to keep people out of the office," notes Long. "Nurses can put patients in appointment slots when they need to be seen. That gives the nurses time to do more patient care." Long's practice is one of two offices in the ThedaCare health care system trying out re-engineering techniques that will eventually affect all 100 of the system's primary care physicians. Same-day access is only part of the comprehensive redesign going on in those two sites. Another strategy affects triage nurses: Instead of having one for each physician, Long's clinic plans to let any available nurse take calls from any doctor's patients. The calls will also be routed directly to the nurses, rather than being screened by receptionists, as they are now. The twin goals are to streamline scheduling and to free the receptionists for other duties. PeaceHealth, an integrated delivery system based in Bellevue, WA, has traveled further down the re-engineering road. One-third of the 50 primary care physicians employed by the system are offering same-day scheduling, and one 10-doctor office has fundamentally reorganized its clinical work processes. Internist Frank H. Littell, one of several physicians who's orchestrating the changes at PeaceHealth, works in the prototype site in Eugene, OR. He's part of a "care team" that includes two other internists and the five staffers who interact with their patients, including medical assistants and an LPN. (The FPs and pediatricians in the office also belong to care teams.) What makes these teams so efficient and boosts their productivity is their physical proximity and the cross-training of staff members. This strong, flexible staff support has been a key to making same-day access feasible in Littell's practice. Another factor was the internists' decision to expand appointment slots from 15 to 20 minutes each. "That's allowed us to dictate the chart right after each visit,
grab the piles of things in the inbox, and deal with any phone calls as
they arise," explains Littell. "So it's a function of being realistic
about the other work that we do beyond seeing patients. That's been the
key. I have added some time to my bookable hours. On the other hand,
my total in-office time has shrunk, because I'm not batching stuff at the
end of the day or at lunch." |
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