© 2009 The McGraw-Hill Companies, Inc. All rights reserved 12-1 Scheduling Appointments and Maintaining the Physician’s Schedule PowerPoint® presentation

12-1

© 2009 The McGraw-Hill Companies, Inc. All rights reserved

Scheduling Appointments and Scheduling Appointments and Maintaining the Physician’s ScheduleMaintaining the Physician’s Schedule

PowerPoint® presentation to accompany:

Medical AssistingThird Edition

Booth, Whicker, Wyman, Pugh, Thompson


12-2

12.1 Explain the importance of the appointment book in maintaining the schedule in the medical office.

12.2 Identify common scheduling abbreviations.

12.3 Identify different types of appointment scheduling systems.

12.4 Discuss ways to arrange appointments for patients.

Learning Outcomes


12-3

12.5 Explain how to handle special scheduling situations.

12.6 Explain how to properly document no-shows and late patients.

12.7 Describe how to schedule appointments that are outside the medical office.

12.8 Discuss ways to keep an accurate and efficient physician schedule.

Learning Outcomes (cont.)


12-4

Introduction Scheduling systems

Types How each is used

Scheduling situations

Appointment book Legal aspects documentation


12-5

The Appointment Book

A well-managed appointment book

• Creates an efficient patient flow• Shows respect for everyone’s time by preventing excessive wait time

Unexpected events that occur

• Early and late arrivals• No-show patients• Emergencies• Physicians spend extra time with patients


12-6

The Appointment Book (cont.)

Preparing the appointment book Create the matrix, or basic

format Block off times the doctor

is unavailable Examples of when time

should be blocked off Hospital rounds Surgery Vacation and holidays Scheduled meetings


12-7

The Appointment Book (cont.)

Computer or traditional paper appointment book

Obtain patient information Patient’s full name Home and work telephone

numbers Purpose of the visit


12-8

The Appointment Book: Commonly Used Abbreviations

Abbreviation MeaningBP blood pressure check

can cancellation

c/o complains of

cons consultation

CP chest pain

CPE complete physical exam

ECG electrocardiogram


12-9

Abbreviation Meaning

FU follow-up appointment

GI gastrointestinal

I & D incision and drainage

inj injection

lab laboratory studies

N & V nausea and vomiting

NP new patient

NS no-show patient

The Appointment Book: Commonly Used Abbreviations (cont.)


12-10

Abbreviation MeaningP & P Pap smear and pelvic exam

Pap Pap smear

PMS premenstrual syndrome

pt patient

PT physical therapy

re recheck

ref referral

RS reschedule



12-11

Abbreviation MeaningRx prescription

sig sigmoidoscopy

SOB shortness of breath

S/R suture removal

surg surgery

US ultrasound

URI upper respiratory infection

UTI urinary tract infection



12-12

The Appointment Book: Determining Standard Procedure Times

Create a standard list of procedure times Indicate how much time to allow for the tests Use only as a guide

Helps identify appointment openings appropriate for the patient visit


12-13

30 min or >

30–60 min

5–10 min

15–20 min

15 min

15–30 min

10–20 min

30 min

5-10 min

10-20 min

15 min

15-20 min

15-30 min

30 min

30 min or >

30-60 min

The Appointment Book: Determining Standard Procedure Times (cont.)


12-14

Keep appointment books for at least 3 years Entries must be clear and easy to read

Never erase a name or use liquid paper Use blue ink and never pencil

Draw a single line through the name Write the date, time, and reason for cancellations Document cancellations and no-shows in patient’s record

The Appointment Book: A Legal Record


12-15

Use your knowledge of abbreviations and scheduling to order these from least time required to most time required. (1= least time required and 5= most time required)

Apply Your Knowledge

S/R

CPE

FU

CAN

P&P

suture removal 10–20 min.3

5

2

1

4

complete physical examination 30–60 min.

follow-up appointment 5–10 min.

cancellation 0 min.

Pap smear and pelvic examination 15–30 min.

ANSWER:

GOOD JOB!


12-16

Appointment Scheduling Systems Goals

Smooth flow of patients Minimal waiting time

Open-hours scheduling No appointments

Patients arrive at their own convenience

Seen on a first-come, first-served basis

Rural practices and urgent care centers


12-17

Appointment Scheduling Systems (cont.)

Time-specified scheduling Stream scheduling

Patients are scheduled for specific times

At regular intervals Time based on reason for the

appointment


12-18

Wave scheduling Large offices

See several patients at the same time Seen in the order of their actual arrival

Flexibility for appointments that run longer than planned Uses an hourly target

Number of patients to be seen hourly determined by dividing 60 minutes by the average estimated length of visits

Multiple patients at the same time can result in Patient dissatisfaction Annoyance



12-19

Modified-wave scheduling Options

Patients scheduled in 15-minute increments Four patients scheduled during the first half hour and the second

half hour is left free for catch-up

Double booking Two or more patients scheduled for the same time

Both patients will see the doctor within the scheduled period One may be seen by NP or PA

Used when patient with no appointment needs to be seen



12-20

Cluster scheduling (categorization) Groups similar appointments together Useful if specialized equipment has limited availability

Advance scheduling Scheduling patients weeks or months in advance, such as

with annual exams Leave a few slots open for patients with unexpected

problems



12-21

Combination scheduling Using two scheduling methods

Computerized scheduling Affords the following advantages

Can “lock out” selected appointment times Information can be accessed from all terminals in the office Help identify patients who are late, miss appointments,

cancel, or require more time with the physician Reports to help improve efficiency



12-22


A large pediatrician office commonly must “squeeze in” patients in that have become ill, so this new office plans to offer immunizations only twice per week. Which scheduling system(s) would you recommend for this medical practice?ANSWER: Combination scheduling consisting of cluster and a form of wave scheduling would be recommended to allow for the needed flexibility.


12-23

Arranging Appointments Offer choices

Dates Times

Accommodate patient’s needs whenever possible

Confirm choice with patient


12-24

Arranging Appointments (cont.)

New patients Those not established at

the medical office

Obtain all necessary information

Name Address and phone number Date of birth Insurance information

Have patient arrive 15–30 minutes early to fill out forms

Return appointments Ask patients if they need

another appointment before they leave


12-25

AppointmentReminders

Appointment cards After appointment time is entered in the book, it is recorded and given to the patient

Reminder calls 1–2 days before the scheduled appointment the office calls the patient

Reminder mailings A postcard addressed to the patient that is mailed one week before the appointment

Recall notices Form letter sent to remind patients to call for an appointment

Arranging Appointments (cont.)


12-26


The doctor wants Mr. Lincoln to return to the office for a follow-up appointment in two weeks. What should the medical assistant do?

ANSWER: The medical assistant should offer Mr. Lincoln a choice of dates and times available to accommodate Mr. Lincoln’s needs. After entering the appointment in the book or into the computer, confirm the date and time with the patient and give him a appointment card.

TERRIFIC!


12-27

Emergencies Seen immediately upon arrival at the office Explain to waiting patients without details

Provide opportunity to reschedule

Referrals Referred patients should be seen as soon as possible When arranging referrals for a patient

Provide choices Be sure the facility accepts the patient’s insurance Document in patient record

Special Scheduling Situations: Patient


12-28

Fasting patients Fast

Refrain from eating or drinking Usually beginning the night before the appointment

Schedule as early as possible

Instruct patient about the need to fast and when to start

Special Scheduling Situations: Patient (cont.)


12-29

Patients with diabetes Require regular meals and snacks to regulate blood

glucose

Consider avoiding late morning slots that are close to lunchtime

Keep appropriate snacks on hand in the event a patient develops a low blood sugar



12-30

Repeat visits Schedule regular appointments on same day and

time

Late arrivals Schedule chronically late patients toward the end of

the day Prevents disruption in the office schedule

Document late arrivals or missed appointments in patient record



12-31

Walk-ins

If it is an emergency, handle as such

If no openings, offer to schedule an appointment

Post a sign in the office if no walk-ins are allowed



12-32

Cancellations Thank patient for calling to

cancel Appropriately mark

appointment as canceled Attempt to reschedule while

the patient is on the phone Document cancellation in the

patient’s medical record

J.Jones 123-456-7890

cancelled

S Smith 098-765-4321

R Hansen 456-789-0123M Fitz 321-456-0987



12-33

Missed appointments Document no-shows in the

appointment book and patient medical record

Inform the physician of no-shows

Wrong day Reschedule if patient lives locally Attempt to accommodate if

patient required special transportation or traveled far

H Plummer 234-543-2345

P. Lexar 098-765-4321

No show



12-34

Physicians may throw the schedule off by Arriving late to the office Returning late from lunch or meetings Being called away for emergencies Being delayed at the hospital

If a physician is late repeatedly, you may want to add some buffer time to the schedule and slot patients accordingly.

Special Scheduling Situations: Physician


12-35


Mr. Washington needs a follow-up appointment in a week for a fasting blood sugar after the physician changed his medicine for diabetes. How should you handle this appointment?ANSWER: The appointment should be made for the first or second appointment for that day. Mr. Washington should be reminded he should not eat or drink after midnight, and that he should not take his diabetes medicine prior to the appointment but should bring it with him.


12-36

Scheduling Outside Appointments

Common outside appointments include Consults with other physicians Laboratory work X-rays and other diagnostic tests Hospitalizations and surgeries

Be sure to have a doctor’s order specifying Procedure When results are needed


12-37

Scheduling Outside Appointments (cont.)

Validate the patient’s insurance prior to selecting the outside physician or facility HMOs often arrange referral and notify office

when approved

Discuss possible appointment times with patient or give patient information to make appointment Give pre-appointment instructions if necessary


12-38


Mr. Anderson calls at 0830 and cancels his 0900 but calls the office again at 1230 c/o redness and discomfort at his surgical site. What should the medical assistant do?

ANSWER: The medical assistants should tell the patient to come right in due his complaints of incision redness and discomfort. However, Mr. Anderson should also be told that he will be “worked in” around other patients’ appointments.


12-39

Maintaining the Physician’s Schedule


12-40

Maintaining the Physician’s Schedule (cont.)

Overbooking Scheduling too many patients Office schedule falls behind Stressful for staff

Underbooking Gaps in schedule Try to schedule another appointment in

cancelled time slot


12-41


Emergencies or delays Apologize to waiting patients

Offer choice Estimated waiting time Leave to run errands and return at agreed-upon

time Reschedule appointment for another day


12-42

Reserving operating rooms Reserve the facility, staff, supplies, and equipment needed Give preferred days and times, types and length of surgeries

Stocking the medical bag Some physicians see patients in nursing home facilities

Block this time in the office schedule The medical assistant may be responsible for stocking the

physician’s medical bag Check expiration dates Supplies must not be taken from the bag in the office



12-43

Scheduling pharmaceutical sales representatives Called detail persons

Some physicians meet with them Block time for this purpose

New representatives Request a business card Check with the physician before scheduling an appointment



12-44

Making travel arrangements Out-of-town meetings or events

Medical assistant may be responsible for Airline arrangements (get itinerary) Car rentals and lodging Get confirmations for all reservations

A locum tenens or substitute physician may cover practice while regular physician is away



12-45

Planning meetings Find out number of people,

length and purpose of meeting

Secure location with adequate room and parking

Prepare an agenda if requested

Secure equipment such as podium and microphones

Take minutes as needed



12-46

Scheduling time with the physician Meet regularly with the physician

Review schedule Other items

State medical license Drug Enforcement Agency registration Documentation of continuing medical education

(CME) requirements



12-47


When making travel arrangements for the physician, which of the following would be the responsibility of the medical assistant?

a) Locum tenens

b) Itinerary

c) Agenda

ANSWER:

Right!


12-48

In Summary Proper scheduling = efficiency

Most medical offices select one or two scheduling systems that fit its practice

Special scheduling situations involve both patients and physicians

Maintaining a physician’s schedule may include making travel arrangements and planning meetings


12-49

Taking a few extra minutes, going that extra mile, and giving that added special touch can make a world of difference in a very difficult situation.

~ Lisa Lockhart

(From A Daybook for Nurses: Making a Difference Each Day)

Documents

© 2009 The McGraw-Hill Companies, Inc. All rights reserved 12-1 Scheduling Appointments and Maintaining the Physician’s Schedule PowerPoint® presentation