Post on 15-Dec-2015
© Access Advisors 2013 Proprietary & Confidential
STRATEGIES TO INCREASE APPOINTMENT UTILIZATION
andENGAGING PROVIDERS FOR CHANGE
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OCTOBER, 2013
© Access Advisors 2013 Proprietary & Confidential
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⧁ This session will provide you with the knowledge to:
Limit the impact of no-show/last minute cancelsImprove providers’ new to return ratioMaximize providers’ scheduling capacityEngage providers in the change management
process
Learning Objectives
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Build for
Capacity
Optimize for
Success
Right Patient Right Place Right Time
The Balance Board
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© Access Advisors 2013 Proprietary & Confidential
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Small Improvements = Big Gains
The Visit Value
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The Advisory Board’s 4 Key Strategies of Survival
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⧁ Set Standards Session durations• <.5 CFTE = 240 minute standard• >.5 CFTE = 210 minute standard
Visit Type durations• Provider time?• Patient room time?
Weeks per year• 44-48 week standard• Why important? — Commitment Report
Follow-up intervals• Standardize across providers, where applicable
Build for Capacity
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⧁ Structure Stagger start/end Time
Double-book first appointment• New with Return
Freeze and thaw slots• Assure New Patient Growth
Maximize Schedule Capacity
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Not Recommended Recommended
Provider Start Time Provider Start Time
Provider A 8:00 AM Provider A 7:45 AM
Provider B 8:00 AM Provider B 8:00 AM
Provider C 8:00 AM Provider C 8:15 AM
© Access Advisors 2013 Proprietary & Confidential
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Maximize Schedule Capacity
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Optimize all your resources• Staff• Parking Resources• Waiting Room Space
© Access Advisors 2013 Proprietary & Confidential
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⧁ Overbook based on no-shows Understand the probability of a no-show
Simple Strategy: Overbook at 10AM & 2PM
Optimize Appointments
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⧁ Programs designed to fill last minute cancels Employee Priority Internal Referring Provider Priority Targeted Waitlist
⧁ Team scheduling / shifting volumes Established / New Providers Mid-levels Patient Choice
Optimize Appointments
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⧁ “Green Light” Patient Scheduling Identify high priority patients at the
point of scheduling• High revenue • High research potential
Outline the 2-3 questions needed to recognize a “Green Light” patient
Reserve “Green Light” visit types to expedite the next available appointments
Track lag time by diagnosis code to validate effectiveness of process
Optimize Appointments
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© Access Advisors 2013 Proprietary & Confidential
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⧁ Measure Minutes available / minutes booked Understand drivers of variance
Optimize Appointments
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© Access Advisors 2013 Proprietary & Confidential
The Two Pronged Approach
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Implementing Rapid Change AND
Deep Dive Sustainable Growth
© Access Advisors 2013 Proprietary & Confidential
Engaged Provider Models
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MU
SC C
ase
Stud
y
© Access Advisors 2013 Proprietary & Confidential
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Common Obstacles to Provider Engagement
“What I do works fine, Why Change? ” “I’m not going to lose control to some administrative group”
“How will this possibly help me”
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MU
SC C
ase
Stud
y
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“What I do works fine ”
Comprehensive data driven review of current state. Department/Division/individual provider. Metrics Lag time New to old ratios New patient growth Clinic DensityTransparency compared to peers
MU
SC C
ase
Stud
y
© Access Advisors 2013 Proprietary & Confidential
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“What I do works fine ”
Comprehensive data driven review of current state. Department/Division/individual provider. Metrics Lag time New to old ratios New patient growth Clinic DensityTransparency compared to peers
Best Practices Like Physicians by specialty Road Trips
MU
SC C
ase
Stud
y
© Access Advisors 2013 Proprietary & Confidential
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“I’m not going to lose control of my schedule to some administrative group”
Set guiding principles
MU
SC C
ase
Stud
y
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MUSC Access Guiding Principles
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Increase volume of new patient arrivals
New patients will be seen within 7 calendar days
Develop a uniform global referral process• One referral form • Develop centralized call center which meets service level goals• Institute post scheduling medical record review process
Maximize appointment availability and utilization• Standardize and reduce appointment types• Standardize master schedule structure• Utilize Clinical FTE Standards for Each Provider
MU
SC C
ase
Stud
y
© Access Advisors 2013 Proprietary & Confidential
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“I’m not going to lose control of my schedule to some administrative group”
Set guiding principles
Establish physician leader group with authority to set policy and allow variances.
Develop Working groups (SWAT Team) Scheduling/Call Center Capacity management Communications
MU
SC C
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Stud
y
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MUSC Leadership Structure
Clinical Leadership Council
Executive Access Committee
Access SWAT Team
Department/Division Level Teams (Physician Champions, Dept. Admin)
Clinical Strategic Plan Coordinating Committee Ap
prov
al
Plan
Pre
sent
ation
s
MU
SC C
ase
Stud
y
© Access Advisors 2013 Proprietary & Confidential
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MUSC Physician Champion Role
• Owner of the Access Initiative for their department/division• Provide the site perspective on specific clinic workflows • Partner with administrator/ business manager to
develop operational solutions for each clinic• Attend monthly meetings with administrator/business
manager• Responsible for communicating updates on the Access
Initiative at their faculty department/divisional meetings• Act as liaison to Access SWAT Team
MU
SC C
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Stud
y
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Clinical Leadership CouncilChaired by Dean Pisano
Senior Leadership of MUHA, COM, and MUSCP
Executive Access CommitteeChairs, CMO’s, & Administrative Leadership MUSCP/ MUHA
Systems Reengineering
Practice Reengineering
Strategic Plan
Metrics
Communications
Department Champions of Medicine: Dr. Don Rockey & Melanie Puckhaber
GI HematologyOncology
ID
Rheumatology Pulmonary Endocrinology
Cardiology GIMG
Division Physician Champions & Business Manager
Dr. Dan Steinberg & Steve
Vinciguerra
Dr.. Frank Brescia &
Sandra Crosby
Dr. Patrick Flume & Derek Sanford
Nephrology
Dr. Michael Ullian
Dr. Corey Hatfield & Dr. Jim
Oates
Dr. Dan Wray Dr. Brenda HoffmanDr. Sam Kwon, Dr. Lou Lutrell & Ted
Wickman
Dr. Dolores Tetreault
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MUSC ACCESS Approval Process
Department Approval
Executive Access Committee Approval
Clinical Leadership
Department/Division’s team of Physician Champion and business manager/administrator develop access strategy
Practice Reengineering
Central Scheduling with Scripting &
Training
Strategic Plan
Metrics
DEP
T. A
CCES
S PL
AN
App
rova
l
MU
SC C
ase
Stud
y
© Access Advisors 2013 Proprietary & Confidential
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Common Obstacles to Provider Engagement
“What I do works fine, Why Change? ” “I’m not going to lose control to some administrative group”
“How will this possibly help me”
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MU
SC C
ase
Stud
y
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“How will this possibly help me”• Financial incentives Alignment Variable compensation tied to Access Goals Chair engagement: bonus
• Nonfinancial incentives Transparent dashboards: capitalize on competitive nature of Physicians
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Lessons Learned
• Consistency• Local leadership: Division Champions• Follow through/Accountability: EAC process• Support from top leaders• Common sense exception/ variance process• Engage nurses/admin/rev cycle• Sufficient Infrastructure• Communicate/Communicate/Communicate• Emphasize Impact on individual provider• Clinical Compact with scheduling: Clear expectations• Realistic Time line
© Access Advisors 2013 Proprietary & Confidential
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MU
SC C
ase
Stud
y
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Brent Bizwell Access Advisors
ConsultantAtlanta, GA
404.973.0060brent@accessadvisors.comwww.accessadvisors.com
Dr. Peter ZwernerMedical University of South Carolina
Chief Medical OfficerAssociate Professor of Medicine & Radiology
Charleston, SC
Que
stion
s?
Questions?