Patient Access: The Journey to Just Say Yes
As part of an ongoing effort to provide the healthcare industry with leading practice information and strategies, FTI Consulting Health Solutions has partnered with Duke Medicine and its Private Diagnostic Clinic (PDC) to assess how to increase the availability of patient appointments in selected departments. The effort involves developing new governance and management structures to engage and challenge all practices to oversee Access using new tools and methods. This introductory paper outlines the activities inside the project as Duke Medicine strives to increase patient access during a time of increased competition, enhanced consumer demand for timely and quality service, healthcare reform, and expansion of hospital facilities, the Cancer Center, and its Private Diagnostic Clinic physical footprints.
The project focuses on two key elements:
1. A new framework to operate and manage the resources tied to the Appointment Management function that engages and collaborates with physicians, seeks to solve the barriers to Access in a collaborative way, and increases accountability to meet standards recently developed by PDC leadership.
2. Use of the “Access Algorithm,” a proprietary tool provided by FTI that measures Access across various specialties in a balanced and unbiased way, “scores” how well Access is achieved by clinical departments, and identifies which areas should be targeted for improvement.
This article also covers how researching, engaging, and at times challenging legacy care models with departmental leaders led to innovation at the department level, sponsored by service chiefs, Vice-Chairs, and business leaders. Strategies were monetized for financial impact including the additional number of patients who could be seen per day and percent increase in overall patient volumes. Topics included the usage of Advanced Practice Provider (APP) resources to independently provide less-intensive services, allowing physicians to open up their schedules to accommodate more new patients, which can also lead to greater downstream revenues for supplementary hospital services. The team also evaluated same day/next day appointment rules, the impact of “bumping,” overall schedule efficiency, and after-hours and weekend services.
Finally, a transition to the Epic practice management system was also underway at this time. Leading practices were identified and shared to help utilize key functions within Cadence to use technologies in a more consumer-focused manner to reduce noshows and cancellations.