By Joseph Mathews

While the patient experience should begin with a seemingly uncomplicated call to schedule an appointment, the patient journey is often marred by hard-to-understand greetings and instructions, abandoned calls, being sent to voicemail, or sitting on hold for long wait times while listening to a barrage of promotions about the organization. These are quite often the result of the “shackles” placed on practices by technology or other complex details of their practice workflows. So, how can collecting data and managing each of these processes from this perspective change the patient experience?

In 2013, our practice began establishing benchmarks for an expected service level in our scheduling department by using data that we had. This helped us determine what we would need moving forward. Service level was calculated as the percentage of calls answered within the first minute by a live person. We identified our “shackles” and began to realize that many other practices experience the same struggles:

• Antiquated phone systems
• Long and complicated initial greetings
• Complex phone tree set up
• Controlling medical teams
• Complex physician protocols
• Additional duties for the appointments staff
• Staff turnover

While we could not fix everything, our practice began to address the items we could control. We moved to a more comprehensive phone system that allowed for more extensive data collection and meaningful reporting, established more effective call routing, created a common appointments que, and established the ability to research calls and call history. We were even able to monitor calls in real time.

We made modifications to our main company greeting that ultimately decreased the length from one and a half minutes, which we previously allocated as “wait time” for the patient, to only 30 seconds.

Our phone tree was in essence a que within a que that required patients to press various buttons to simply reach the correct person who could schedule for physician. Once the patient reached the correct phone line for the scheduler, the patient then had to wait on that extension until their call could be answered. We used call data to analyze and manage our phone tree more efficiently, making it less complicated and reducing patient’s extended hold time. The modified phone tree removed all prompts and allowed for scheduling to be done by the employee who answered the call. This also led to a more capable and multi-faceted staff that is able to handle scheduling for all our physicians, thus adding value to their roles within the practice.

We further addressed the demands of our medical teams by spreading some responsibilities to the medical assistants and moved towards standardization of our physician protocols by decreasing the amount of triage performed at the appointments level. We focused on empowering our scheduling staff through increased training and support, minimizing the additional duties that they were assigned, and removing some of the rules that previously prevented them from attaining the highest levels of productivity and efficiency.

All aspects of the patient scheduling experience were benchmarked, and parameters for tracking and reporting were established. The parameters include average time to answer calls, average time to call abandonment, percentage of voicemails left, total of abandoned calls and total calls received. This has allowed for a stronger management approach where we are able to go beyond month-to-month analysis and measure on a day-to-day basis, which allows for improvement on a daily basis. The journey was tedious, but the move to data-based management increased our scheduling service level from 58 percent in 2013 to 84 percent in 2017. We now have measureable and attainable goals for our staff, managers, and practice to ensure that every point of the patient experience reflects our desire for excellence.

Joseph Mathews, PT, DPT is the practice administrator for Advanced Orthopaedics and Sports Medicine in the Houston area. In addition to serving on the Texas Orthopaedic Association’s Board of Directors, he serves on the American Association of Orthopaedic Executives’ Advocacy Council.