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Glenn Morley

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Tips to Enhance Flow and Efficiency During COVID

Tips to Enhance Flow and Efficiency During COVID

Based on conversations with many clients and a recent reopening survey we conducted, we know that clinic flow and patient scheduling have been challenging for practices amid increasing practice activity, navigating COVID-safety measures, and doing more, often with fewer staff. However, despite those complexities, we at BSM have seen practices make creative and effective changes to meet needs for efficiency, productivity, safety, and team morale in an altered environment.

With an open mind and adjusted goals, practices have been able to tap into new and existing resources to effectively meet practice demand. We are optimistic that many of these efforts will stand the test of time and will forevermore change operations in a positive way both for the practice and the patient. We share below some of the most noteworthy modifications we have observed, hoping they may prove useful in your own clinic.

Noteworthy Modifications

Assessing technology and investing in both hardware and software updates. As COVID was beginning to impact us in the U.S., many practices were caught “flat-footed” without the technology or protocols to effectively work in a virtual-based world. Since then, many practices have invested in laptops for essential workers, remote access of the practice management system (PMS) and electronic medical records (EMR), as well as additional technology training. These wise investments have allowed staff to remain nimble and perform many clinical and nonclinical functions remotely (e.g., patient triage, scheduling, consultations, lead management, and some follow-ups), allowing practices to re-tool patient flow and better meet today’s evolving environment.

Providing technology training to staff. Many flow, efficiency, and communications solutions during the past six months have occurred because of better use of existing technology and investment in pertinent technology training. Ensuring all staff is equipped with the right technology as well as the training needed to maximize its effectiveness has been both a morale boost and additive to the bottom line for many practices. One best practice that has emerged as new technology is being implemented has been to ask staff members to “become the patient” and go through the same virtual steps and processes asked of patients. For instance, staff completing new patient paperwork through the practice portal. By walking in the patient's shoes staff members gain a better understanding of the technology, have a chance to see things from the patient perspective, and can speak with authenticity on technological matters.

Implementing portal use. Many practices that had not previously embraced patient portals pre-COVID are now big fans. The challenges related to COVID and the resulting reliance on virtual communication have underscored the value of portal adaptation. Simply put, use of these portals during the pandemic has become pivotal to efficient patient care and safety as it serves to reduce in-office patient time. Efficient and direct communication with clinical staff via the portal around medications, post-procedure care, and other patient concerns reduce and streamline communications, which is a win for both the patient and practice.     

Providing tech support for patients. Additional reliance on the use of technology by patients has highlighted the need to help those less IT–savvy learn how to adapt to unfamiliar resources. Practices with an older clientele have identified a need for both live tech support via trained staff as well as simple, short video tutorials. Ideally, these video tutorials are filmed by doctors because patients pay close attention to what their doctor says. A doctor’s self-deprecating humor in one video tutorial we saw convinced us that even an older patient would believe the provider who assured viewers, “If I can sign into the portal and communicate with my doctor, anyone can do it!” It is important for patients to know how to use the technology, so they are more apt to use it. This, in turn, allows practices to utilize technology in opportune instances to streamline the overall patient encounter and communications.

Mapping each patient visit type through the office. Nothing is as effective in identifying efficiency opportunities than mapping a patient visit with a workflow diagram. This activity should be undertaken periodically with the team to identify any instances for doing things differently whether it’s in the pre-visit, visit, or post-visit phase of the encounter. Challenge the team with these questions to identify areas of opportunity and make the appropriate adjustments.

  1. Can any element of the pre-arrival process be enhanced? Before COVID, many patients arrived for their visit without having completed new patient paperwork. Today, many savvy practices use the need to limit patient time in the office as an opportunity to insist on the completion of paperwork in advance. Re-setting these expectations means patients can be roomed upon arrival, streamlining the patient intake portion of the visit.
  2. How can patient movement into and out of exam rooms be minimized? Making sure that all rooms are appropriately stocked for provider needs as well as in-exam room scheduling and check-out have been effective efficiencies. Having clinical staff review the schedule and double-checking the alignment of the time scheduled with the visit reason, and then aligning the preparation of the exam room on the day of the visit can definitely eliminate provider or patient wait times.
  3. Should we hire runners? This is a new role in some practices. Runners literally run products (or literature, or anything needed) to a room when messaged by a provider. Runners can also be trained to greet patients at the door for a temperature check, mask check, and symptom check; as well as ensure hand sanitization and that clear signage remains intact. Practices have found that performance of these small yet essential tasks by a nonclinical staff member can be instrumental in freeing up other clinic personnel to carry out specific and essential duties that cannot be delegated, resulting in a smooth clinic flow.

Recording short patient education videos. This is an excellent option for physicians who repeat the same “spiel” to multiple patients throughout the day. By memorializing those important patient education soundbites in a video that patients can view either before their visit or in the exam room prior to the provider entering, physicians are finding that they can reclaim some of their limited time. The 2-4 minutes previously spent per patient on education and repeated four to six times a day over a 4-day clinic week can conceivably free up more than an hour and half each week. In that time, the physician and practice could see a significant number of additional patients, keeping the patient flow moving. 

Embracing telemedicine. While the in-office physical exam is still an important part of medical visits, COVID has shown us that with the proper technology and know-how many visits can be effectively managed virtually. This is evident by the explosive growth of companies like Teladoc, a multinational telehealth and virtual health care company, whose Q2 total visits increased by 203 percent as a result of the pandemic. With a goal of getting back to pre-COVID patient volumes, many practices have been able to increase their overall patient throughput through an effective balance of in-person and virtual patient visits that can be effectively managed across the provider team. This has been achieved by offering more exam rooms and support staff to each provider during in-person clinic sessions and by concurrently scheduling telemedicine visits with the other providers. Virtual encounters are being embraced by many patients and can certainly help to reduce wait times and eliminate transportation and parking issues. It would not be surprising if telemedicine emerges as a long-term mainstay in routine medical care.

It's Not too Late

If your practice has implemented any of the above modifications and have found them to be beneficial, it would make great sense to hang on to them as operations return to normal. If not, it is definitely not too late to start! Running an efficient practice is a timeless goal, so keep that in the forefront when planning for a successful 2021.

NEED HELP? Contact our Practice Operations team to learn how to improve your practice flow and efficiency.  


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