Efficiency in Motion: 5 Steps for Better Practice Workflow

Published: Jan 16, 2017
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Manage your workflow, or it will manage you. This is the mantra of practice management consultants everywhere.

The concept is certainly sound: Get everyone in the practice doing what needs to be done, when it needs to be done, and in an efficient manner.

Contrast this to inefficient workflow and all those times you’re left waiting for someone else to do their job so you can do yours. The classic example is having to delay a procedure because the exam room wasn’t stocked and you can’t find a nurse.

Poor workflow isn’t just tough on staff – it also spills over to patients. Think of the patient who signs in at the front desk and sits down, only to be called back three more times when staff requires additional information.

Problems With Processes

Most workflow issues can be traced back to problems with processes, not with people. With poor processes, nothing is ready when it needs to be. With efficient processes, less time, effort and resources are required to produce the desired outcomes.

Whether it’s patient check-in or handling refills, each process requires a series of steps that must be accomplished correctly, in the right order and at the right time. Consider these five steps for taming the workflow beast at your practice:

Map your processes. Pick a current process and create a flow map of exactly how it plays out. Begin at the point where the patient engages the process and then list all the steps in order of completion.

Map out the process on a whiteboard, stick post-it notes on the wall or simply sketch it out on paper to create a detailed description of the entire process. Identify bottlenecks and wasted time by measuring the cycle time of a process. This is often as simple as having a staff member follow several patients through the entire process with a stopwatch at different times of the day.
Challenge each step of a process. You’ll find that certain steps are simply a waste of time and energy. Throw those out and focus on the steps that add value to the process – these are the ones that produce good results every time. They are available whenever needed and can quickly adapt to fluctuations.
Find and remove bottlenecks. Understand that there are roadblocks that are episodic and those that are constant. For example, does tight staffing throw a wrench in things only when a key staff member calls in sick or takes vacation (episodic)? Or, do you feel the pinch at the same time every day (constant)?

If staffing is a constant problem, a possible solution would be to stagger staffing hours to create a late-afternoon nursing position so you always have end-of-the-day coverage without having to pay overtime.
Agree on an improved process. Once you see all the steps and the complexity of the process, you can begin thinking of ways to simplify and improve it. It might be something as basic as moving the steps in the process closer together – for example, changing the physical location of people and facilities to reduce steps and facilitate communication.

Likewise, many processes can be improved by intelligent use of technology and automation. One example: Using an EHR to check drug interactions instead of having to leave the exam room to chase down a pharmacy reference.
Help the new process succeed. You can’t mandate a new process and expect it to succeed. You must educate staff and equip them with all the information they will need. Utilize daily huddles to identify and prepare for any variations that may occur in the process that day.

Also, educate your patients about the new procedures. For example, if you need patients to verify their preferred pharmacy, post a well-worded sign in the exam rooms asking them to stop by the nursing station on the way out.

Bottom-Line Payoff

When you think through the time and money lost to chasing charts and responding to pharmacy calls, it should become clear that there is a bottom-line payoff to improving practice workflow.

Healthcare Practice Strategies - Winter 2017