Improving Your "Touch Time"<

by: Elizabeth Woodcock, MBA, FACMPE, CPC

Ten Surefire Tips For a Faster Patient Cycle

Now I've heard everything: A practice manager recently told me about a patient who ordered a pizza for delivery to his exam room. The patient was waiting for such a long time for the doctor to see him that he ordered, received, and ate the pizza before the physician walked in the door. We laughed about it, but the patient assuredly was not equally amused.

The story highlighted the need for this physician's office to improve its operations.

Even if they're not ordering pizza, the old adage, "I love my doctor, but I hate his office," may roll off many of your patients' tongues.

Indeed, your office may be one of many in need of help in reducing the lengthy waits and delays that frustrate patients and plague office efficiency. These delays contrast with the "touch time" patients want and need with their care team. It's this time with patients that probably attracted you to medicine in the first place, and it's this time that is compensated by our reimbursement system, creating a merging of goals for all parties involved.

Few would argue that there is plenty of room for improvement. Your office can take steps to ensure that your patients have a positive experience.

Consultant Deborah Walker Keegan, PhD, advises starting with your patients. "The key to success is to design your patient flow process around the patient - not the physician or the nurse," she says. "The patient flow process should be patient-centered and physician-led in order to reduce cycle time and meet or exceed patient expectations."

When applied to a physician office, "cycle time," an engineering term, refers to the time from when the patient enters the office until her exit. Although many office visits can be accomplished in 60 minutes or less, beating this cycle time - or some other specific time benchmark - should not be considered the goal of a cycle time performance improvement initiative. The goal is to make sure that the percentage of time valued by the patient - the touch time - is the highest it can be.

10 Steps to More Touching

To maximize touch time, follow these 10 steps:

1. Schedule appropriately. Most often, lengthy patient waits are a result of poor scheduling on the part of the office. Dick Haines, an architect and president of Medical Design International, has seen too many doctors set themselves up for disaster. He urges physicians to identify how many patients they can see in a specific time period. The appointment schedule should be configured to match this rate of production, such as four patients per hour. "Otherwise," he says, "patients can be brought in much earlier than they can possibly be seen ... and they will be forced to wait."

2. Don't double-book. If the schedule you established reflects your productivity, double-booking means extending patient waits. Haines notes, "Doctors don't work faster because someone in the business office puts more patients in a time slot than they can see. When that happens, everything jams up and patients who had an appointment are unnecessarily delayed." Instead, determine which slots may be available by holding some for same-day scheduling, and using a daily staff/physician huddle to determine if slots may be open unexpectedly - for example, an obstetrics patient who delivered the evening prior. (More on huddles in step 5.)

3. Be prepared. Before the patient even walks through the door, make sure that you're ready for him. This process should begin with a chart preview days before his appointment. Scrutinize the chart to ensure that all of the information the physician needs is in place. This includes results from tests ordered, hospital discharge summaries, and any communication from physicians to whom you referred the patient. Physicians should summarize their orders in w<

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