When managing a health clinic, it is inevitable that patients will be lost. A portion of these patients are due to pure attrition; such as patients moving, getting new insurance, and death. Most likely, those patients represent only a small portion of your lost patients and for the rest of the patients your health center is losing, it is at a significant financial loss to the health center when they leave.
In order to begin to identify and tackle the problems leading to patient loss, one must ask, why are patients leaving? What factors are leading to patients going elsewhere for their care rather than continuing to turn to your providers and staff? And lastly, where do I begin?
The first step to most scheduled provider visits is a phone call from the patient to a scheduler. Over the course of a week, call your scheduling line multiple times and at different times of the day (For a true patient experience, do not use your office or cell phone as caller ID may get you preferred treatment when the call center sees a health center executive is calling). How long do you wait, on average, to speak with a scheduler? Are you always able to speak with someone? Also, when you have dialed in, is there an automated system that you must navigate to schedule an appointment and if so, is it simple to navigate? As this begins the patient experience for a visit, consideration must be put into how simple or difficult it is for a patient to schedule an appointment.
The next part of this exercise will take you to the parking lot of your clinic. Your parking lot plays a significant role in how your patients’ experience begins when they arrive at your clinic. Let’s start with the obvious. Stand in your parking lot at a peak hour. Are there a sufficient number of handicap parking spaces? I am not talking about enough required by law, but are the handicap spaces full and do you see others parking elsewhere that would benefit from additional handicap spaces? Is there enough parking in your lot and does traffic flow easily? And lastly, before you go through the glass doors to enter the clinic, look at the landscaping. Is it neat and tidy or are the shrubs overgrown with weeds growing through cracks in the pavement? Appearances matter. To the patient, they may wonder ‘if the exterior appearance isn’t important, what corners may be getting cut inside the clinic?’
Walk into your clinic, take a seat for an hour, and begin to observe and asking yourself questions. Is the room well lit? Is it brightly painted? Are the chairs comfortable? Are the magazines outdated? If there is a tv, is what’s showing appropriate and worth paying attention to? Also, take note of the general mood of everyone in the room. Do they seem comfortable and in a generally good mood?
While you’re taking this all in, make note of how the front desk staff interacts with your patients. Are they warm and inviting or are patients merely told to sign-in, fill out the paperwork, and take a seat? Once the patients are seated, note how long they wait until their name is called to go to their assigned exam room. With a watch, a pen and paper, you will quickly develop a feel for the initial patient experience. If what you have encountered up until this point adds up to a negative experience, the tone has been set for the rest of the visit.
“Understanding how your processes and procedures impact patient flow through your office will improve the patient experience and your bottom line.” -Nick Fabrizio, PhD, FACMPE, FACHE
The next step will be to identify your patients’ cycle times. This is an integral part of understanding the patient experience. An October 2018 MGMA poll determined that 50% of responding healthcare leaders did not track cycle times while 9% were unsure. “Understanding how your processes and procedures impact patient flow through your office will improve the patient experience and your bottom line,” according to Nick Fabrizio, PhD, FACMPE, FACHE.
For those tracking cycle times in their EMR, you cannot rely on just that data as they are prone to human error. Ask yourself if that data is accurate and then go check for yourself. Don’t just track how long your patients are spending in the clinic, but how much of their time is spent with a member of the care team, with their provider, and how long are they spending alone.
*1 in 5 patients say they have switched doctors because of long wait times.
*30% of patients have left a doctor appointment because of a long wait.
Vitals’ 2018 Physician Wait Time Report showed that 30% of patients admit to having walked out of a medical appointment due to long wait times and 1 in 5 patients said they changed providers because of long wait times. This proves that it is crucial that your health center develop a real understanding of what your patients’ true cycle times are. The same report also noted that 53% of patients who reported limited access to healthcare stated that they had left an appointment because the wait time to see their provider was too long. These are the most vulnerable patients that are having to leave their exams because wait times are long.
As you sit at a nurses’ station collecting real cycle time data, make note of inefficiencies. What could be improved to lessen the time your patients are waiting alone? How is communication between providers and care team members? Are providers searching the halls for a nurse or MA to communicate a care plan or because they need assistance while multiple patients are roomed and waiting to be seen? If a patient has an issue and exits the exam room because of a long wait, how does your staff respond? Is there a protocol in place? You will find that this time spent collecting information will be well spent as you develop an understanding of your patients’ experience at the clinic.
Patient Retention and Loss
Why go through this exercise as it means spending your valuable time away from your day-to-day work? Consider this hypothetical situation: If a clinic has 5,000 patients and an attrition rate of 20%, that means 1,000 patients will leave the clinic. And, keeping with round numbers, let’s say that each patient has a lifetime value of $1,000. Those patients lost equates to $1,000,000 of missed revenue. In this hypothetical scenario, you have two options: find 1,000 more patients to replace the lost revenue or work to build your retention rates. By addressing identified issues and making the necessary changes to address those issues, you will work to build your retention rate. In this scenario, a modest growth of 5% to the retention rate would mean retaining 250 more patients.
By taking the time to develop an understanding of your patients’ experience, by addressing identified issues and inefficiencies, you will find patient satisfaction scores will rise, retention rates will grow, and less revenue lost due to patients leaving your clinic.
At SyncTimes, we offer an integrated hardware and software solution to community health centers that employs lean methodology to improve patient flow management. On average, our clients see a 12% reduction of patient alone time and a 6% increase in provider productivity within the first year of implementation. During this same period, surveys show significant growth in patient satisfaction.
Our solution will include placing touch-screen tablets at exam rooms and larger monitors at shared workspaces. When implemented, medical assistants, nurses, and providers will have the ability to more simply communicate the needs of the patient. No longer will your providers have to search the halls for a team member between visits. They will walk from one exam room to the next knowing that the care plan has been communicated. With better communication, cycle times will decrease and patient satisfaction will improve.
SyncTimes provides a tool to help providers and their care teams, communicate more effectively, providing for an elevated level of care to your patients. Administrators and clinic manager are provided insight into what patients are experiencing and where improvements can be made, as well as optimizing scheduling, staffing, and creating efficiencies to clinical workflows.
We would welcome the opportunity to help your health center to provide for a better experience for both your patients and staff.