Interested in saving time by learning how to use the current visit to prepare for the next? What about working as a team to make rooming and discharge more efficient?
Standardizing and streamlining these practice fundamentals and core workflows—and optimizing teamwork to share that workload—can help physicians and team members feel less frustrated and help clinics or health systems run more smoothly, while providing more opportunities to handle unanticipated issues that come up during the day.
The “AMA STEPS Forward® Saving Time Playbook” can help physicians and health systems reduce burnout by being more efficient and working smarter, not harder. In turn, physicians will have more time to take care of patients and themselves. Learn more by reading, “Want to save time in your practice? There’s a playbook for that.”
Use pre-visit planning, lab tests
The playbook highlights the core components of a team-based patient care workflow for an ambulatory visit. Among them is a team-based approach to planning for a patient appointment—with a mindset of “the next visit starts today”—saving time, cutting practice costs and improving patient care. It can be a key piece to helping a practice run smoothly and handle any unanticipated issues that arise on a given day.
Pre-visit planning includes scheduling future visits and arranging for pre-visit labs. It can:
- Empower care team members to close potential care gaps before the physician sees the patient.
- Allow patients and team members to schedule several future planned care appointments at once.
- Help ensure the appropriate time intervals are followed for appointments and associated labs in a reminder system when a visit planner or open-access scheduling system is used.
This time and cost savings calculator can help determine how much a practice or health system will save by incorporating pre-visit laboratory testing.
“Once I implemented pre-visit labs, our office saved hours each week, which helped us stay on schedule,” said AMA member Marie T. Brown, MD, who is a geriatric and internal medicine specialist at Rush University Medical Center and director of practice redesign at the AMA. “I was concerned my patients would resist coming in for a blood test a few days—but most really appreciated being able to discuss lab results face-to-face, adjust meds and not play phone tag after the visit.”
The AMA STEPS Forward “Pre-Visit Planning” and “Pre-Visit Laboratory Testing” toolkits can help you dig deeper into how to incorporate these time-saving workflows.
Adopting annual prescription renewals
When patients and pharmacies call into the practice for prescription refill or renewal requests, it can eat up precious time for physicians and other team members in the practice. Instead of fielding calls on a monthly basis, physicians can proactively renew all of a patient’s long-term medications for chronic conditions once per year, at the same time, for at least 12 months and ideally for 15 months.
The change can save up to five hours of unnecessary work each week by writing a prescription for a 90-day supply with four refills. A handful of states even allow renewal for up to 24 months. Learn more with the AMA STEPS Forward toolkit for “Annual Prescription Renewal.”
Follow rooming and discharge protocols
Expanding rooming and discharge protocols by allowing other team members to take on additional responsibility gives physicians the opportunity to spend more time directly interacting with patients and their care partners. It also helps ensure that patients understand and remember their discharge instructions.
For example, nurses or medical assistants can print and review an updated medication list and visit summary during discharge. During rooming, they can be the ones to identify the reason for a visit and help the patient set a visit agenda.
The AMA STEPS Forward “Advanced Rooming and Discharge” toolkit can help your practice or health system make the changes.
Adopt team triage
When patients have acute care needs, they tend to call multiple times, send multiple patient portal messages or even go to emergency departments or urgent care centers when they can’t get a timely response.
Developing triage protocols for phone calls and patient portal messages can change patient behavior. Determine what acute care needs can be resolved via protocol without an additional appointment with a physician, which ones can warrant an in-person visit, and determine whether a particular concern needs to be addressed by interrupting the physician or if the physician may need to speak to the patient.
Other ways to build a strong triage workflow include holding morning huddles and doing an “end-of-day-sweep” across the practice to resolve any outstanding patient needs before the practice closes. The AMA STEPS Forward “Patient Portal Optimization” toolkit provides more guidance on efficient triage.
Close the loop on referrals
Referring physicians shouldn’t be responsible for making sure a patient gets seen, so a strong referral system is key in creating efficiency. This includes a “close-the-loop” protocol for high-priority referrals and orders that establishes additional oversight to monitor if patients have missed necessary care. Some organizations employ nurses or other clinicians to review medical charts. The goal is to prevent physicians from needing to keep their own “follow-up” lists, which add an unnecessary burden. It also creates a system to identify high-risk care gaps.
The “Saving Time Playbook” includes highlights from multiple AMA STEPS Forward toolkits. It is part of the AMA STEPS Forward program, which offers innovative strategies that allow physicians and other members of the practice team to thrive in the new health care environment. These resources can help you prevent physician burnout and improve practice efficiency.
