© Access Advisors 2013 Proprietary & Confidential STRATEGIES TO INCREASE APPOINTMENT UTILIZATION and ENGAGING PROVIDERS FOR CHANGE 1 OCTOBER, 2013

© Access Advisors 2013 Proprietary & Confidential

STRATEGIES TO INCREASE APPOINTMENT UTILIZATION

andENGAGING PROVIDERS FOR CHANGE

1

OCTOBER, 2013


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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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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


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Maximize Schedule Capacity

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Optimize all your resources• Staff• Parking Resources• Waiting Room Space


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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


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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


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⧁ Measure Minutes available / minutes booked Understand drivers of variance


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The Two Pronged Approach

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Implementing Rapid Change AND

Deep Dive Sustainable Growth


Engaged Provider Models

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MU

SC C

ase

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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

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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

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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

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“I’m not going to lose control of my schedule to some administrative group”

Set guiding principles

MU

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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

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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

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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

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Plan

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sent

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MU

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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

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Stud

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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

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MU

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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

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Stud

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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


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MU

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Stud

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Brent Bizwell Access Advisors

ConsultantAtlanta, GA

[email protected]

Dr. Peter ZwernerMedical University of South Carolina

Chief Medical OfficerAssociate Professor of Medicine & Radiology

Charleston, SC

Que

stion

s?

Questions?

Documents

© Access Advisors 2013 Proprietary & Confidential STRATEGIES TO INCREASE APPOINTMENT UTILIZATION and ENGAGING PROVIDERS FOR CHANGE 1 OCTOBER, 2013