Keep Patients Waiting Not in My office

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- Prepare a schedule starting at 9 A.M. for the following patients of Dr. Schafer.

Johnny Appleseed, a splinter on his left thumb.

Mark Borino, a new patient.

Joyce Chang, a new patient.

Amar Gavhane, 102.5 degree (Fahrenheit) fever.

Sara Goodsmith, an immunization.

Tonya Johnston, well-baby checkup.

JJ Lopes, a new patient.

Angel Ramierz, well-baby checkup.

Bobby Toolright, recheck on a sprained ankle.

Rebecca White, a new patient.

Doctor Schafer starts work promptly at 9 A.M. and enjoys taking a 15-minute coffee break around 10:15 or 10:30 A.M. Apply the priority rule that maximizes scheduling efficiency. Indicate whether or not you see an exception to this priority rule that might arise. Round up any times listed in the case study e.g., if the case study stipulates 5 or 10 minutes, then assumes 10 minutes for the sake of this problem).

PATIENT REASON FOR VISIT TIME

Gavhane, Amar High Temperature (102) 9:00 – 9:30

Appleseed, Johnny Removal of splinter 9:30 – 9:40

Goodsmith, Sarah Immunization 9:40 – 9:50

Johnson, Tonya Well baby check-up 9:50 – 10:05

Ramirez, Angel Well baby check-up 10:05 – 10:20

OPEN 10:20 - 10:30

BREAK 10:30 – 10:45

Toolright, Bobby Sprained ankle re-check 10:45 -10:55

OPEN 10:55 – 11:05

Barino, Mark New Patient 11:05 – 11:35

LUNCH 11:35 – 12:35

White, Rebecca New Patient 12:35 – 1:05

OPEN 1:05 – 1:35

Lopez, JJ New Patient 1:35 – 2:05

OPEN 2:05 – 2:35

Chang, Joyce New Patient 2:35 – 3:05

OPEN 3:05 – 5:00

The priority rule that I see with this scenario is SOT (shortest operating time). I have tied to schedule his patients in need of services (more critical care patients) in the morning with his check-ups and new patients later on in the day. These type of patients can sometimes take a little longer and thus with the way I scheduled these there is opportunity for Dr. Schafer to take some more time getting to know his new patients as well as see if there is anything that is troubling them right now that could use immediate attention.

CONCLUSION:

Though it is difficult to please everyone (especially sick patients) providers and hospital administrators must find ways to better keep themselves and their staff on-time with their patients scheduled times. Hospitals and providers must try different approaches and types of schedules that best suit their type of practice. The longer a patient waits the unhappier they become. Some actually leave without treatment (known as LWOT) and in hospitals these are patients are tracked to determine if the Emergency Room is adequately staffed with both doctors and nurses so as to take care of the volume being seen. Hospital administrators are concerned when patients leave without treatment as they are not sure how sick and or injured a patient may have been and when patients leave without treatment they are usually very dissatisfied with the facility. In this day and age when people are unhappy there are too many ways to “get the word out” via social media. Hospital administrators and office managers struggle with trying to keep the reputation of their respective areas positive due to these scheduling and wait time issues.

When tackling the difficult task of attempting to reduce patient wait times, practice managers and hospital administrators need to focus more on the patients experience and less on the sheer numbers. Though there will be push back from corporate headquarters of from a Chief Executive Officer to see as many with a little of resources as possible they managers must hold to their stance of patient satisfaction and care before revenue. If providers are rushed to see the next patient then something could be over looked or misdiagnosed. These types of incidents could result in law suits and ensuing costs that are more than taking more time with a patient and seeing less patients or expanding the staff so as to be able to see more patients carefully and thoroughly. Healthcare providers are strapped for resources and time is the most valuable resource. Hospital administrators and practice managers need to try different approaches so as to determine what scheduling model will work best for their responsible areas. They must find ways to improve access for patients to be seen and to be seen on their scheduled time frame (a little delay is usually understandable) so as to keep patient satisfied.

Some providers have implemented a patient portal to where a patient can log in and ask questions or tell a healthcare provider what symptoms they are experiencing so as to get some treatment without even having to come in for an office visit. Healthcare providers respond to these emails and may indeed inform the patient that they need to come in for a visit or go to the emergency room or that the provider has called in a prescription for them at their local pharmacy.

Those that take the initiative to implement changes so that their patients are seen according to the schedule will find more satisfied and loyal patients that will help them grow their business.

There are some physician offices that give their patient text message updates. This helps not only in informing the patients but also works as a reminder. There are some potential issues with systems like this regarding to privacy. Permission first must be granted (preferably in writing) for the patient to receive text messages regarding their appointment times. The system should be confined to only give information about the time of the scheduled visit and not get into the reason as to what the visit is for.

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