Improve Office Productivity:
Ten Steps To A Better Office Workflow
So much has been studied, written and debated about workplace efficiency that it is surprising every business doesn’t just hum along at peak productivity levels. As far back as the ancient Greeks Plato predicted that, “All things will be produced in superior quantity and quality, and with greater ease, when each man works at a single occupation, in accordance with his natural gifts, and at the right moment, without meddling with anything else.”
Since then, everyone from St. Francis of Assisi to Lee Iacocca, Walt Disney and Steve Jobs have weighed in on productivity. Time and motion studies are conducted ad nauseam, dissertations are written for MBA schools, and millions of dollars are spent on books that hold the next big idea in productivity creation.
The dream of an efficient and productive medical practice seems just as unreachable as it did when doctors traveled all over town to visit patients. Even with centralized care locations, multiple office personnel providing assistance, improved electronic gadgetry, and technical wonders in diagnostics, doctors still spend vast amounts of time on mundane office tasks and administrative duties that have nothing to do with providing a higher quality of care.
Just when it seems efficiency could not get more elusive, medical practices are slammed with new mandates requiring improved chronic care management, increased levels of patient engagement, and escalated efforts to comply with the Promoting Interoperability (PI) Program, all in the name of quickly transitioning to a value-based healthcare system.
Is it any wonder that so many medical practices feel they are in a constant uproar? Faced with dealing with patients, communicating with internal and external providers, providing concise chart notations, and arguing with insurance companies and Medicare over payment levels, many providers simply throw up their hands and give up in defeat.
In 2017, Medical Economics Magazine published the results of the 88th Annual Physician Report. Entitled, “Ambivalence Wreaking Havoc in Primary Care,” the article reported on a growing sense of ambivalence among many primary care physicians which stems from frustration with the mountains of paperwork and reporting requirements that eat up ever larger chunks of precious time. It revealed that patient care time in 2016 had decreased to an average of 85 patients per week for family doctors and 76 patients per week for general internists. Even with all physicians working at a maximum capacity, this only produces enough appointment opportunities for 65-70% of the patient population, leaving some people to go without optimal levels of care.
Reasons given for these decreased levels of productivity include an aging population with increased multiple-condition needs, slow adaptation to efficient Electronic Health Records (EHRs), poor internal productivity standards, razor-thin profit margins which lead to staff shortages, and the exhaustive regulatory framework in which most practices must somehow manage to survive.
Negative Impacts of Poor Medical Practice Efficiency
Poor productivity and low office efficiency can lead to a dysfunctional medical practice. The results of this toxic environment include:
Poor Staff Communication
Inefficient operations lead to multiple personnel performing the same function or, even worse, nobody performing it. Arguments abound as staff members assign blame, or time is lost as they complain among themselves.
No Defined Chain of Command
Offices that are not organized efficiently lead to the feeling that nobody is in charge. Duties are not clearly defined, and nobody has the power to settle minor disagreements.
Failure to Comply
Not being organized enough to stay in compliance with a myriad of requirements could result in poor practice revenue management, CMS penalties, civil fines, and increased insurance premiums.
Delays in Responding to Patient Care Needs
Patient engagement is a critical issue for medical providers. Antiquated or inefficient systems deny patients the ability to keep in touch with their medical care provider and adequately participate in their own healthcare management.
Anxiety and a feeling of unease can cause health problems, loss of sleep, burnout and anger issues for providers and office staff. Morale can plummet and personnel may miss office time for personal doctor visits, or they may just call in sick.
Loss of Creative Input
Office staff are the most likely to recognize issues and recommend solutions, but they may feel less inclined to provide comments or share ideas about how to improve the practice if they believe it will not have a major impact.
Ineffective time management or clunky charting software may lead to sloppy charting habits. This could result in multiple tests being ordered for the same patient or critical symptoms being missed, and widens the potential for medical errors and potential malpractice claims.
Negative Impacts on Patients
At the very least, an inefficient practice results in long wait times, a failure to respond to incoming communications, and poor coordination with insurance providers. This might simply result in patients moving to another practice. At most, the practice might not follow-up sufficiently or monitor testing levels for patients with chronic issues, which could result in health care gaps.
Decreased Practice Revenue
An inefficient practice is one that is not making the best use of its resources. Personnel and patient turnover might be high, money could be spent on needless or redundant activities, and the physician will feel an increased sense of defeat as profits continue to plunge.
While it might not seem like the most important task on the doctor’s to-do list when compared with providing life-saving or life-enhancing care, the need to improve office efficiency and productivity must be acknowledged so that care is provided in the most efficient way possible.
Steps to Take to Improve Office Workflow
When put under the microscope, it can be seen that there are some obvious reasons for inefficiency. The trick is to acknowledge these areas and take steps to improve efficiency to create a smoother functioning medical practice. Here are factors that are most likely to hurt your practice, and some ideas to improve your daily workflow:
1. Unstop Bottlenecks
Every minute counts in office productivity. It is crucially important that patients flow smoothly through each stage of a visit. New patients can complete and submit onboarding paperwork online before the appointment, so there is no lag time when they arrive. Have someone open the office early so there is no delay in registering the day’s first patient. The in-office process starts with automatic appointment reminders to reduce no-shows, and continues with the reception desk. The front office personnel need to be aware of appointment times, advise patients of possible delays, and update insurance and contact information. Use updated software to discuss financial responsibilities and process any co-payments, before patients are put into a room. Patients should be moved as quickly as possible to examination rooms where someone checks their vitals and takes a brief reason for the visit. This information should be immediately available to the provider to eliminate redundancy in talking with the patient. Prescriptions and diagnostic tests can be ordered immediately through a more efficient software system without requiring additional office steps. Follow-up appointments should be scheduled on check-out.
2. Study Office Layout
Take some time to walk through the office flow as a patient might experience it. Try to determine where bottlenecks may occur so they can be eliminated. Then ask your office staff what changes they would make to have the office operate more efficiently. You might be surprised to learn that they spend an awful lot of time running around the office because it is not arranged to conveniently support their work flow.
3. Name an Office Administrator
The medical provider should not be the one making daily decisions about office minutiae. Name a staff member to handle these questions, settle office logistics questions, and manage efficiency matters.
4. Chart More Efficiently
Inefficient charting is one of the biggest time wasters in many medical practices. Time is lost dictating and transcribing notes, or additional costs are incurred to have a scribe in the room taking notes during the appointment. Better charting technologies are available with frequently used templates and voice-recognition tools to significantly reduce the amount of time spent in this activity.
5. Share More Effectively
Another big time waster is copying records to share information with other providers. This has become such a concern that the Promoting Interoperability (PI) Program was put into place just to address this issue. Not only is it required, it also makes it easier to share requested information with the click of a mouse.
6. Use a Patient Portal for Communication and Follow-Up
Telephone calls waste valuable time in trying to contact patients waiting for test results, or respond to those with questions. Providers can schedule time on the patient portal to address these inquiries more efficiently, and also schedule appropriate time for chronic care management with the designated portion of the patient population.
7. Stop the Backups
Sometimes a practice falls behind on its daily appointment schedule, despite the best efforts of staff and providers to maintain efficiency. Emergencies happen, equipment breaks, or staff members may be trying to cover for others who are out of the office. If your schedule starts to slip, give patients in the reception area the option of waiting, leaving and returning, or rescheduling. It is better to have a reschedule than to have a patient who notices the lack of efficiency and decides never to return.
8. Review the Good, Bad and the Ugly
Sometimes the day just gets off track and never gets back on. Take a few minutes to review what happened with the staff, and don’t be afraid to accept responsibility for your role in any setbacks. Ask for suggestions and implement changes to try to prevent the same backups from happening again.
9. Bill Better
At the end of the day, it is all a waste of time if the bill is not calculated correctly and sent out immediately. Use the latest in billing software to electronically submit bills that are accurate and result in a higher rate of claims paid on first submission.
Take time to generate, review and think about reports that are generated about your practice. Look at appointments, view claims, and keep on top of data you need to know.
Managing productivity might not have a glamorous feel to it, but it can certainly have a big impact on you, your staff, patients and revenue when it is done correctly.