The work of primary care is carried out through administrative and clinical workflows that are often complex, sometimes without the opportunity to reflect on the effectiveness or efficiency of the workflow itself. Below are a few tips to ensure effective patient flow.​

  1. Assess how a patient encounter progresses from the patient's point of view. This can be done by shadowing a patient through the visit, (eg, using a kitchen timer attached to a clipboard or notepad where staff notes encounter times).
  2. Start from the initial appointment scheduling, the electronic health record (EHR) review. Identify the points of care where staff engage with the patient and prep for the visit. The process can then be reviewed as a team (providers, front desk, clinical, and billing staff) to identify areas that increase delays.
  3. Patient flow congestion can occur during the check-in process, provider appointment times, interruptions in providers' workflow, documentation practices, cleaning and set up of examination rooms, clinical processes, scheduling, as well as patient checkout.
  4. Prioritize changes based on staff, provider, and patient survey information. Initiate one change per area at a time; ensure that adaptation and evaluation is complete before going on to the next one.

Goals to consider should focus on improving the overall satisfaction of providers, staff and patients all while increasing revenue and cutting expenses of the practice. 

Identifying the flow of patients may also have an immediate effect on revenue. The location of the checkout or collections desk can have a significant effect on co-payment collection. As the patient checks out after the visit, a properly placed desk can improve contact with the patient and increase chances for collection. Co-payments are often given less attention in the world of collections because of the small amounts, but these dollars can quickly add up.  

By making sure that all patients pass by the checkout desk before leaving the office, this can provide another opportunity to collect the co-payment as the patient schedules the next appointment. 

Additional ​Examples I​​nclude: 

Streamline Front O​​ffice ​Tasks 
Front office staff are typically the first presence that patients and families come in contact with either via phone or face-to-face. It is critical that the first impression is a pleasant one. In order to decrease wait times and increase organization, the front desk staff should be responsible for: 

  • Scheduling appointments 
  • Collecting payments 
  • Verifying insurances 
  • Making sure patient forms are completed properly​ 

Use MAs and RNs ​as Flow Managers 
As a vital member of the pediatric practice team, Medical Assistants (MAs) and Registered Nurses (RNs) should manage and complete back-office tasks as a way to deliver and improve high quality clinical care to patients. Back-office tasks can include: 

  • Exam room preparation 
  • Answering patient questions 
  • Gathering clinical information for providers (eg lab results, x-ray reports)​​ 

Optimize Patient Sc​​he​dules 
In terms of delivery of care, patient scheduling is one of the most crucial operational systems in a practice. For provider, staff and patient satisfaction, it is important to maximize patient appointments and minimize the downtime that happens when patients fail to show up. 

Additional Resources: 

Last Updated

07/30/2021

Source

American Academy of Pediatrics