Schedule definitions. We begin with definitions to ensure you become familiar with our terminology, understand how to generate accurate stats, and to grow your knowledge so that you can identify better lead measures to move the needle for positive change and achieve your wildly important goals.
The first column is dedicated to terminology, followed by definitions, industry benchmarks, and examples of how to apply the information based on best practice. Let’s jump right in and read through each term and definition.
Patient schedule. The patient schedule or appointment book determines the health of your clinic. With no appointments, there are no fees generated for products or services. Begin by evaluating your schedule design including; appointment duration, ratio of problem-focused to comprehensive exams slots available, ratio of new patients to established patients exam slots available, your breakeven, staff productivity rate, and finally the emotional capacity and pace of your eye care provider. Your business is only as good as your database. Maintain a robust schedule database by asking for all forms of contact information, and update each patient demographic while making the initial appointment, or checking the patient in for their appointment.
Projected values. Projected values are essential to keep score. Populate your projected values up to one year in advance, and one month in advance at minimum.
Projected clinic hours. Number of hours anticipated to be available on the patient schedule or ECP schedule. Example, a clinic that is open from 8 a.m. to 5 p.m. with one hour blocked for the ECP’s lunch break. This would count from 8 to 12 as 4 clinic hours and from 1 to 5 as 4 additional clinic hours. This is a total of 8 clinic hours. So, if your business is open from 8 am – 5 pm, however, the patient schedule is closed for an hour, that is a total of 8 clinic hours. Clinic hours are the foundation for which you will measure many other statistics and so it is essential that this measurement is calculated correctly and consistently.
ECP days. ECP is an abbreviation for eye care provider. One ECP day equals 8 clinic hours. So if you total your week and you see that you have a total of 40 clinic hours, that is also a total of 5 ECP days. Williams Group previously referred to ECP days as doctor days. The terminology has changed, but the equation to calculate the value has not. We hope your team has already calculated projected ECP days for the year 2021 and be sure to sit down with your ECP to determine 2022 projected ECP days by June of 2021. Consider using a master calendar to provide an overview of all calendars including; national holidays, ECP vacation days, ECP continuing education days, and staff time off. Be sure to close your patient schedule if your ECP will be out of the office, or if your office plans to be closed for a holiday.
Schedule design. Schedule design is essential to fulfill business objectives and achieve balance for demand, receipts, and staff productivity. A predictive schedule design model will set your clinic up for success. Schedule is so key guys. Your schedule design will also help normalize your staff schedule, increase productivity, and create a consistent patient experience. A typical ECP will need to see 14-16 comprehensive exams, 4 ECP days a week, for 48 weeks out of the year, at $400 receipts per patient, to reach the standard 1.2 million dollar mark. Beyond receipts, controlling costs are necessary to ensure a net profit high enough to support the ECP after cost of goods expenses, labor, loans, marketing, fixed, and other variable expenses are paid.
Appointment slots. Categorize your appointment types into three buckets; comprehensive exams, problem-focused exams and no fee exams, or contact lens follow-up exams. Total exams is used to calculate ALL three appointment categories to tally patient encounters each day/week/month/year.
Actual values. Actual values can be generated manually or through your software platform reporting function, also called an EHR or practice management system. Actual values are assigned to a staff member by tab or department. Once your ECP day is complete, populate the actual values to build data and measure results. Each staff reports results to the doctor on a daily basis, so if you are the team leader for this schedule scoreboard, that would be you. Use all corresponding task lists to record lead measures; the person responsible to create accountability and plan of action determined to move the needle for positive change. Lead measures tell you if you are on track to hit your goal while lag measure tells you if you’ve achieved the goal.
Actual clinic hours. Number of hours actually available on the patient schedule.
Refractions. A refraction measurement is provided to compare refractions quantity to comprehensive exam quantity. In the event your refractions are much higher than your comprehensive exams, we’ll recommend a self-audit to identify under coding tendencies and use the white cells on the stats page at the top of each month to calculate the actual refraction count.
Comprehensive exams. Comprehensive exams may also be referred to as a yearly vision and eye health exam, a routine exam, or a visual assessment. They typically include a refraction, a new prescription, and an optical sale.
Comprehensive exam goal. The schedule design of each ECP will determine your comprehensive exam goal. The goal may vary if your clinic hours vary from day to day. If you have multiple ECPs, combine their goals.
Comprehensive exams booked. The best teams are proactive with schedule management. Record your booked appointments two weeks ahead of time to identify days with empty appointment slots, and work to fill the days closest to today’s date. Update every day to stay on top of schedule management. So guys, what that’s going to look like is from today forward, going ahead and calculate two weeks out and that might be five business days plus another 5 business days, and then you’re going to do this exact same thing the next morning, so you’ll record the actual exams kept for today and then move on to comprehensive exams booked for the next two weeks, which will extend that timeline to continue including exams as you go throughout the month.
Comprehensive exams kept. Kept exams are counted at the end of each day after all cancellations, reschedules, and additions. Kept exams are appointment slots where the patient shows up for their appointment on time. If the patient is five minutes late, be sure to call them to see if everything is okay. This also teaches your patients that they matter and their absence does not go unnoticed. You may need to reschedule the patient if they are not close to your clinic. Be sure to see the patients that show up on time first, in the event a patient shows up 10-15 minutes late. If the patient needs to be moved to a later appointment time, create a new appointment to indicate that the appointment slot was not filled on the original appointment time. This is also lost productivity time. Doing so leaves an accurate reflection of the patient’s appointment history.
Problem-focused exam. To develop a medical ratio, it’s important to know percentage of problem-focused exams, as well as percentage of diagnostic testing in relation to comprehensive exams, in order to grow a medically-based practice and ensure clinical care standards are being met.
Problem-focused exam goal. The schedule design of each ECP will determine your problem-focused exam goal. The goal may vary if your clinic hours vary from day to day. If you have multiple ECPs, combine their goals. For best practices, we are looking for 49% problem-focused exams in comparison to comprehensive exams. For example, that would be 49 problem-focused to every 100 comprehensive.
Problem-focused exams booked. Following clinical care guidelines will drive your problem-focused encounters. Record your booked appointments two weeks ahead of time to identify days with empty appointment slots, and work to fill the days closest to today’s date. In the event you have a patient booked who has not confirmed, ensure your office has a process in place to address the situation, such as, double booking if not confirmed within 48 hours. You may also look at the appointment history to see if the patient is a chronic rescheduler or no shower.
Problem-focused exams kept. Kept exams are counted at the end of each day after all cancellations, reschedules, and additions.
No fee follow up exams. These appointments will generally be for contact lens checks, which is a no-charge visit typically, within one week after the initial fit, prescription, or material or modality change. Including data collection for no fee follow up exams will allow you to see exactly how many patients your clinic encounters per day. So this is the third type of appointment bucket. If you remember, we have comprehensive, problem-focused, and now these no fee or follow-up contact lens exams.
No show appointments. Number of patients who were booked, but did not keep their appointment or communicate a need to reschedule. No show status is for both confirmed and unconfirmed appointments. In the event you have a patient no show, who was never confirmed, ensure your office has a process in place to address the situation, such as, double booking if not confirmed within 48 hours. You may also look at the appointment history to see if the patient is a chronic rescheduler or no shower. Record the appointment status as no show if you were unable to fill the appointment slot, because this is lost productivity time.
No show percentage. Percentage of booked appointments that no showed, typically resulting in lost productivity time.
Exam goal trackers. The exam goal trackers were created to have a running total of kept appointments compared to the predetermined or projected goal. Utilizing this tracking tool will allow your team to identify if today was a winning day, and if not, plan accordingly to make up for the lost appointments, especially those comprehensive exams. Slide the schedule and utilize a concierge list to eliminate lost productivity time, and ensure exam goals are met. Communicate with your ECP and rally with your team daily, to stay on top of your goals.
Total patient encounters. Thanks to your stat tracking skills, you now have a full view of your patient makeup, or total patient encounters. This includes new and established patients.
Next, we have new patient, established patient, no show appointments, and fill rate. Your schedule fill rate has been broken out based on booked exams versus goal, kept exams versus goal, schedule goal versus schedule designed capacity, and kept appointments versus designed appointment capacity.
This was a great introduction. Now, let’s head over to the stats page.