Notes Helper Questions

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Slides 3:
Michelle Bahling
Department Administrator in Orthopedic Surgery
Oversees HR, Finance, Strategy
1) What are you currently doing to reduce wait times? Is it working or not and why?
a. High volume practices 50-60 patients in a day
i. Wait times are variable around programs (ie Total Joint has lower wait
times)
ii. Appointments for x-rays etc beforehand
iii. Some doctors taking more patients than others – some work more
efficiently than others, but patients might have less satisfaction
iv. Shorter appointments
v. Reflection on what went wrong and corrective action
2) What do you think is the biggest factor contributing to the long wait times?
a. Standardization
b. People doing what feels right to them
c. Overbooking depending on provider and what they thought they could happen
d. Providers say no limit to how many patients but patients are frustrated because
of wait times
e. Late patients and doctors – When patients are late its the call of the provider Depending on what they are being seen for. More essential visits may impact
other appointments
3) How do you apply Lean to help reduce patient wait times?
a. Have doctors look at template: how long? Slot time? appropriate number of
new patients, time in between new patients, try to make the best fit practice
style, not everyone can get through the conversation at the same time – shorter
appointments
b. Take into account ortho will need x rays, patients need x ray appointment on
schedule in advance
c. Contributing factors when patients are late and physicians
d. Had Lean Consultant come in and spent a lot of time observing where waste
was – Exam rooms were not stocked the same, which caused confusion when
using a different exam room and sometimes required staff to go to a different
supply closet (during the visit) to get supplies.
e. Allow people to step back and really think about process, know how to fix
issues on the fly, normally don’t have time to step back and look at process
f. Look at data to make sure it supports what they believe
4) How do you ensure wait times are measured in real time?
a.
5) What methods were used to find the root cause of the increased wait times?
6) Are you solving the problem by starting at the root cause or by making small adjustments to
what you can to create more immediate results?
7) What are patient thoughts on the wait times they face?
Deciding whether or not they will see patients if they’re late. The decision is up to the
provider, if it concerns their health, they will still see them. Trying to find the right solution
Patients taking morning off of work
Patients who are really angry their time is just as important as Doctor’s time, direct anger
towards everyone but the Doctor
Doctors with strong interpersonal skills have more forgiving patients
Michelle Bahling
Department Administrator in Orthopedic Surgery
Oversees HR, Finance, Strategy
Physicians may have 20 minutes follow up appointment
One may have 10 minutes for everything
Looking at staffing model to see how they work
Schedule is made through collaboration with physician and his team
Not sure of root cause= but solutions come from staff ( where are they having issues)