It’s easy to stick with a poor schedule. After all, there doesn’t seem to be any time to improve it. The irony: Continuing to follow a poor schedule may actually create time, specifically, the open appointment slots of those patients who, due to long wait times, decide not to return to the practice. Also, this smaller patient base likely will be served by a smaller team, as some staff members will leave the practice due to frustrations over inefficiencies.

A successful, or efficient, schedule, however, has many benefits, including happy patients and staff, increased productivity, and financial stability, all of which sustain and can grow a practice.

Here, I provide the specific action steps that have enabled my practice to create a successful schedule.

Registering patients strategically

When scheduling a patient, front-desk staff are now aware of and, therefore, use the range of time needed per reason for appointment. This way, patients are penciled in, in the most appropriate time slots. Strategically scheduling patients reduces backups, rushed exams and, thus, unhappy patients and staff members.

For example, if a patient is presenting for an assessment of their specialty contact lenses and eye health as a result, staff now know that a 30-minute time slot is needed for these patients.

Additionally, my staff schedule Medicare and new patients in a 20-minute time slot, as Medicare patients tend to have medical issues, in addition to ocular ones, and new patients have no history at the practice.

Further, urgent cases are promptly addressed, while also accommodating for regular appointments.

Offering patient self-scheduling

We offer online scheduling for a certain amount of exam slots. The office staff has full control of the books to monitor this schedule throughout the week. The online schedule process does not allow for double bookings.

Pre-appointing patients

We pre-appoint comprehensive exam patients before they leave the office. Those patients are sent reminders at one month, two weeks, one week, and one day before their appointments via text, or email (if the patient has a valid email address), if their appointment has not yet been confirmed. This action step decreases the likelihood of no shows.

If patients do not confirm their appointment by the day before their scheduled visit, staff call the patients. If there is no answer, staff work to fill the slot with a patient on the waiting list. This is overseen by our main scheduler.

Reviewing patient records before an appointment

Reviewing charts begins with the front office staff. They confirm the appointment, verify insurance, and prepare the flow sheet.

Flow sheet preparation consists of noting both vision and medical insurance plans, any past special testing, and the last ICD-10 codes used.

Minimizing patient/staff traffic

My staff has taken note of bottlenecks in the patient journey, so we can come up with a plan to solve them.

Recently, for instance, we had a traffic jam of patients waiting to undergo pretesting for their exams in our patient workup room. The workup room housed VA testing, a fundus camera, autorefractor, and tonometer, among other testing technologies.

To prevent this traffic jam from continuing, we determined pretesting in the workup room would consist of fundus screening photos and autorefraction. VA, tonometry, etc. is now employed in the exam lane. This has freed up the use of the pretesting equipment, creating a streamlined patient flow, while enabling a balanced workflow for our technicians.

Considering exam room/staffing ratio

We now track the ratio between exam rooms and staff. Think of it this way: If a practice has one exam lane and no tech support, asking techs to run on 15-minute time slots is unrealistic (and, therefore, stressful for them). However, if there are multiple rooms, techs and/or refracting techs, seeing patients every 15 minutes is doable.

Something else to keep in mind: We have been tracking exam room utilization to determine whether we are at capacity and need to add more doctor coverage or open more exam slots. My scheduling template has always had an exam scheduled every 15 minutes, with two easy, quick checks double booked within the hour. We recently changed this to 10-minute slots. If an office is using every slot available and double booking, then their exam utilization is extremely high, and they can take on another doctor. A key metric that we follow is at 75% exam utilization, we need another doctor for growth and to provide optimal patient care.

Automating responses to common patient questions

Our staff has scripted responses for patient questions. One great example is when a doctor takes vacation. Staff know not to let the patients know we are on vacation (we want to play it safe regarding our homes). They will instead say, “Dr. ________ does not have any available appointment slots that day.”

Using a patient survey

To make sure we are meeting our patients’ expectations in scheduling, my practice uses a patient satisfaction survey to determine wait times, so we can see where additional efficiencies can be achieved in the patient’s journey. Every comprehensive exam patient receives a survey. Recently, a survey candidate was a new contact lens fit. The patient’s appointment was scheduled in the middle of the morning block at 10:00 am. This patient had difficulty with contact lens insertion and removal and expressed feeling rushed by the trainer. Based on this patient’s input, we determined it would be better in moving forward to schedule new contact lens fits in the appointment slots the hour before lunch and the hour and half before closing, if it met the patient’s scheduling needs. This is because these blocks allow for additional time to be spent with the patient.

Meeting monthly

Communication among all staff regarding scheduling issues is also crucial to successful scheduling. To ensure we stay on top of any snags in the schedule, we meet monthly to exchange feedback and discuss ways of enhancing productivity to keep both patients and staff happy.

For example, we recently implemented a new triage process for office visits and emergency appointments. Specifically, the scheduler who triages fills out a form consisting of the patient’s chief complaint and pertinent information. If the scheduler is unsure whether the patient needs to be added to that day’s schedule, they present the triage form to the doctor to make the final decision. This has helped tremendously with patient flow and pushback from the technicians.

Make the time

Because the strength of the schedule directly equates to practice success, it’s imperative optometrists and their staff members make the time to review it for improvements. Remember: A poor schedule can alienate patients and staff alike, making the need for one null and void. Additionally, efficient scheduling facilitates better coordination among health care professionals and staff, ensures smooth patient handoffs, enables timely communication, and allows for interdisciplinary collaboration when needed. All lead to more comprehensive and coordinated care. Meanwhile, rushed appointments due to poor scheduling can compromise patient safety by increasing the risk of errors or overlooking crucial details. OM

DR. REYNOLDSON practices at River Valley Eye Clinic, and Camden Eyecare Associates. She graduated from Southern College of Optometry in Memphis, and completed her residency in Ocular Disease. She opened cold in 2003 at the River Valley location, and then purchased Camden Eye Care Associates the following year. She is currently finishing her MBA degree.