Y khoa, dược - Scheduling appointments and maintaining the physician’s schedule

12Scheduling Appointments and Maintaining the Physician’s Schedule12-212.1 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 Outcomes12-312.5 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.)12-4IntroductionScheduling systemsTypes How each is usedScheduling situationsAppointment bookLegal aspectsDocumentation12-5The Appointment BookA well-managed appointment book Creates an efficient patient flow Shows respect for everyone’s time by preventing excessive wait timeUnexpected events that occur Early and late arrivals No-show patients Emergencies Physicians spend  extra time with patients12-6The Appointment Book (cont.)Preparing the appointment bookCreate the matrix, or basic formatBlock off times the doctor is unavailableExamples of when time should be blocked offHospital roundsSurgeryVacation and holidaysScheduled meetings12-7The Appointment Book (cont.)Computer or traditional paper appointment bookObtain patient informationPatient’s full nameHome and work telephone numbersPurpose of the visitUse only approved abbreviations12-8Determining Standard Procedure TimesCreate a standard list of procedure timesIndicate how much time to allow for the testsUse only as a guideHelps identify appointment openings appropriate for the patient visit12-930 min or >How Long Will Each Take?Complete physical examinationNew patient visitFollow-up office visitEmergency office visitPrenatal examinationPap smear and pelvic examMinor in-office surgerySuture removal30–60 min5–10 min15–20 min15 min15–30 min10–20 min30 min5-10 min10-20 min15 min15-20 min15-30 min30 min30 min or >30-60 minDetermining Standard Procedure Times (cont.)12-10A Legal RecordKeep appointment books for at least 3 yearsEntries must be clear and easy to readGeneral Tips... 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 record12-11Use 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 KnowledgeS/RCPEFUCANP&Psuture removal 10–20 min.35214complete 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!12-12Appointment Scheduling SystemsGoalsSmooth flow of patientsMinimal waiting timeOpen-hours schedulingNo appointmentsPatients arrive at their own convenienceSeen on a first-come, first-served basisRural practices and urgent care centers12-13Appointment Scheduling Systems (cont.)Time-specified schedulingStream schedulingPatients are scheduled for specific timesAt regular intervalsTime based on reason for the appointment12-14Appointment Scheduling Systems (cont.)Wave schedulingLarge offices See several patients at the same timeSeen in the order of their actual arrival Flexibility for appointments that run longer than plannedUses an hourly target Number of patients to be seen hourly determined by dividing 60 minutes by the average estimated length of visitsMultiple patients at the same time can result inPatient dissatisfactionAnnoyance 12-15Appointment Scheduling Systems (cont.)Modified-wave schedulingOptionsPatients scheduled in 15-minute increments Four patients scheduled during the first half hour and the second half hour is left free for catch-upDouble-bookingTwo or more patients scheduled for the same time Both patients will see the doctor within the scheduled periodOne may be seen by NP or PAUsed when patient with no appointment needs to be seen12-16Appointment Scheduling Systems (cont.)Cluster scheduling (categorization)Groups similar appointments together Useful if specialized equipment has limited availabilityAdvance schedulingScheduling patients weeks or months in advance, such as with annual examsLeave a few slots open for patients with unexpected problemsCombination scheduling – Using two scheduling methods12-17Appointment Scheduling Systems (cont.)Computerized scheduling – advantagesCan “lock out” selected appointment timesInformation can be accessed from all office terminalsHelp identify patients who are late, miss appointments, cancel, or require more time with the physicianReports to help improve efficiencyOnline scheduling – patients make own appointments via the Internet12-18Apply Your KnowledgeA 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.Right!12-19Arranging AppointmentsOffer choices DatesTimesAccommodate patient’s needs whenever possibleConfirm choice with patient12-20Arranging Appointments (cont.)New patientsThose not established at the medical officeObtain all necessary informationNameAddress and phone numberDate of birthInsurance informationHave patient arrive 15–30 minutes early to fill out formsReturn appointmentsAsk patients if they need another appointment before they leave12-21AppointmentRemindersAppointment cardsAfter appointment time is entered in the book, it is recorded and given to the patientReminder calls1–2 days before the scheduled appointment, the office calls the patientReminder mailingsA postcard addressed to the patient that is mailed one week before theappointmentRecall noticesForm letter sent toremind patients to call for an appointmentArranging Appointments (cont.)12-22Apply Your KnowledgeThe 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!12-23Special Scheduling Situations: PatientEmergenciesSeen immediately upon arrival at the officeExplain to waiting patients without detailsProvide opportunity to rescheduleReferralsReferred patients should be seen as soon as possibleWhen arranging referrals for a patientProvide choicesBe sure the facility accepts the patient’s insuranceDocument in patient record12-24Special Scheduling Situations: Patient (cont.)Fasting patientsRefrain from eating or drinking – usually beginning the night before the appointmentSchedule as early as possible in the dayInstruct patient about the need to fast and when to start12-25Special Scheduling Situations: Patient (cont.)Patients with diabetesRequire regular meals and snacks to regulate blood glucoseConsider avoiding late morning slots that are close to lunchtimeKeep appropriate snacks on hand in the event a patient develops a low blood sugar12-26Repeat visitsSchedule regular appointments on same day and timeLate arrivalsSchedule chronically late patients toward the end of the dayPrevents disruption in the office scheduleDocument late arrivals or missed appointments in patient recordSpecial Scheduling Situations: Patient (cont.)12-27Walk-insIf it is an emergency, handle as suchIf no openings, offer to schedule an appointmentPost a sign in the office if no walk-ins are allowedSpecial Scheduling Situations: Patient (cont.)12-28CancellationsThank patient for calling to cancelAppropriately mark appointment as canceledAttempt to reschedule while the patient is on the phone Document cancellation in the patient’s medical record J. Jones 123-456-7890cancelledS Smith 098-765-4321R Hansen 456-789-0123M Fitz 321-456-0987Special Scheduling Situations: Patient (cont.)12-29Special Scheduling Situations: Patient (cont.)Missed appointments Document no-shows in the appointment book and patient medical recordInform the physician of no-showsWrong dayReschedule if patient lives locallyAttempt to accommodate if patient required special transportation or traveled farH Plummer 234-543-2345P. Lexar 098-765-4321No show12-30Physician Scheduling SituationsPhysicians may throw the schedule off byArriving late to the officeReturning late from lunch or meetingsBeing called away for emergenciesBeing delayed at the hospitalIf a physician is late repeatedly, you may want to add some buffer time to the schedule and slot patients accordingly.12-31Apply Your Knowledge 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.SUPER!12-32Scheduling Outside AppointmentsCommon outside appointments includeConsults with other physiciansLaboratory workX-rays and other diagnostic testsHospitalizations and surgeriesBe sure to have a doctor’s order specifyingProcedureWhen results are needed12-33Scheduling Outside Appointments (cont.)Validate the patient’s insurance prior to selecting the outside physician or facilityHMOs often arrange referrals and notify office when approvedDiscuss possible appointment times with patient or give patient information to make appointmentGive pre-appointment instructions if necessary12-34Apply Your KnowledgeMr. 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 assistant 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.Very Good!12-35Do Not OverbookDo Not UnderbookMaintain a BalanceMaintaining the Physician’s Schedule12-36Maintaining the Physician’s Schedule (cont.)OverbookingScheduling too many patientsOffice schedule falls behind Stressful for staffUnderbookingGaps in scheduleTry to schedule another appointment in cancelled time slot12-37Maintaining the Physician’s Schedule (cont.)Emergencies or delaysApologize to waiting patients and give an estimated waiting timeOffer choiceLeave and return at agreed-upon timeReschedule appointment for another dayReserving operating rooms Give preferred days and timesProvide type and approximate length of procedure12-38Maintaining the Physician’s Schedule (cont.)Scheduling pharmaceutical sales representativesBlock time for this purposeNew representatives Request a business card Check with the physician before scheduling an appointment12-39Maintaining the Physician’s Schedule (cont.)Making travel arrangements for out-of-town meetings or eventsMedical assistant may be responsible forAirline arrangements (get itinerary) Car rentals and lodgingGet confirmations for all reservationsA locum tenens or substitute physician may cover practice while regular physician is away12-40Maintaining the Physician’s Schedule (cont.)Planning meetingsFind out number of people, length and purpose of meetingSecure location with adequate room and parkingPrepare an agenda if requestedSecure equipment such as podium and microphonesTake minutes as needed12-41Maintaining the Physician’s Schedule (cont.)Schedule regular time with the physicianReview scheduleOther itemsState medical licenseDrug Enforcement Agency registrationDocumentation of continuing medical education (CME) requirements12-42Apply Your KnowledgeWhen making travel arrangements for the physician, which of the following would be the responsibility of the medical assistant? Locum tenens Itinerary Agenda ANSWER:Right!12-43In Summary12.1 The appointment book is important in a medical office because it shows respect for the physician’s time and creates an orderly and efficient patient flow.12.2 Commonly used abbreviations save space and time when entering information into an appointment book.12.3 There are several different types of appointment scheduling systems. They range from open-hours scheduling to computerized scheduling.12-44In Summary (cont.)12.4 When arranging appointments for patients, be courteous and polite. Offer different dates and times; always confirm the appointment by repeating it to the patient.12.5 Special scheduling requires creativity and flexibility. 12.6 Document late arrivals and no-show patients. Call to discuss reasons for lateness or no-show. 12-45In Summary (cont.)12.7 Before scheduling outside appointments, ask the doctor for exact procedures that need to be performed, and which results will be needed.12.8 Your job as a medical assistant is to keep the physician’s schedule accurate and efficient. Do not overbook or underbook.12-46Taking 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)End of Chapter 12