What if you could find a way to see an additional patient each day, without spending more time at the office? Or a way to manage staff absences without throwing the practice out of whack? How about improving your team’s spirit and motivating staff to give 110%? If we’ve peaked your interest, read on. Some of our Practice Management Committee members share their best practice efficiency tips below. We’re certain you’ll find an idea or two to boost productivity in your practice.
Cross-train staff, rethink your supplies and use NPs and PAs.
James Tracy, DO, FACAAI – Omaha, Nebraska
1. Cross train staff to handle multiple roles.
We have a medical assistant (MA) as a receptionist who has been trained to give allergy injections and prepare charts. Another MA does prior authorizations and injections. We also train non-clinical staff to handle biologic prior authorization requests. This frees up our clinical staff to take on other responsibilities.
2. Rethink where you have supplies delivered.
Consider having supplies delivered directly where they’ll be used and/or stored rather than to the front office. This will keep the front office less cluttered and avoid the extra step of moving them. We have all packages delivered to our infusion area.
3. Use Nurse Practitioners (NPs) and Physician Assistants (PAs).
We have three PAs supporting eight allergists and 18 locations. Our PAs see only follow up patients, which frees up allergists to see new patients. The PAs also provide shot coverage at high volume clinics when no allergists are present.
Use NPs and PAs for follow-up visits and use mobile tech.
Melinda M. Rathkopf, MD, FACAAI – Anchorage, Alaska
1. Use NPs and PAs for routine follow up visits, acute visits and shot room coverage.
We have one NP and one PA supporting 5 allergists at one location. Our NP and PA do routine follow-up visits (like annual immunotherapy visits), not new patient visits. They often have more availability to see acute visits quickly and are the first to respond to shot room reactions. They are an invaluable addition to our clinic and allow me to focus on more complex patients.
2. Use mobile technology with patients.
I utilize mobile technology with patient care, and use apps for reference tools and patient education. Some of my favorite apps are listed below. (Note: these are not endorsed or recommended by the College.)
My top personal apps:
- Evernote – a great way to organize emails, files, notes, thoughts, etc; can forward an email directly to Evernote.
- GoodReader – my preferred PDF reader. There are multiple other PDF readers out there.
- SignNow (requires a subscription) – a great way to be able to fill out forms and sign documents on your tablet.
- TripIt – great travel organization tool. Works well for groups if one person in your office organizes the business travel.
My most used medical apps:
- Epocrates – drug database.
- Formulary Search – can put in the drug and insurance policy to see if covered.
- UpToDate (requires a subscription – check out the College discount) – very good medical reference organized by topics.
- Doximity – a social site for doctors; can share a case, articles, thoughts, etc; have a HIPAA compliant fax number so can receive faxes on my iPad.
- Specific journal apps – (ex: NEJM, JAMA) a great way to keep up on your journals without having to carry them around.
Apps recommended to patients:
- GoodRx – help patients find the best prices for their prescriptions.
- SkinSafe – database of products to help patients with contact dermatitis.
- AllergyEats – lists restaurants that are friendly for patients with food allergies.
- Pollen counting apps – multiple versions but not all list all pollen counting stations.
- KagenAir – combines pollen counts and air quality reports for patients with allergies and respiratory issues.
Use voice recognition, a text expander, incentivize staff and use a patient tracker.
John Tole, DO, FACAAI – Opelika, Alabama
1. Use voice recognition software to document patient visits.
For years I used a popular voice recognition software, but it uses too much memory and you can only use it on one computer. I have since moved to a cloud-based program which does a better job of voice recognition and corrections. It can also be used on any computer or device with your vocabulary databank synchronized automatically.
2. Use a text expander program with your EHR.
If you find yourself repeating the same text over and over, I recommend a text expander program. A text expander allows you to create simple shortcuts for typing common sentences or paragraphs. For example, if I type the letters ab (for acute bronchitis) and hit the Control key, the program creates the following text:
- Advair HFA 230/21 sampled as 2 puffs twice a day for the next 1-2 weeks
- Systemic steroid
- Codeine-guaif as needed and scheduled at night
I can synchronize my databank on DropBox so I can use it on any device.
(ACAAI note: Check with your EHR vendor to see if they have a similar built-in feature you can use without having to purchase and integrate other software).
3. Incentivize staff to do their best.
An unexpected bonus and a quick “Hey, you’re doing a great job. Keep it up!” goes a long way to motivate staff. This fall our nurses and MAs had a competition to see who gave the most flu vaccines. At the end, I gave surprise bonuses to recognize their extra effort. I calculated the net profit from flu shots and gave 25% for 1st place, 15% for 2nd place and 10% for 3rd place. I also gave 5% to each of the two billing employees.
4. Use the Patient Tracker option in your EHR to analyze workflow and identify bottlenecks.
The patient tracker allows us to track a patient through the visit from checked in, to nurse ready, to physician ready, to procedure in progress, to provider done, etc. Analyzing data for a couple months will help you understand where you have workflow issues.
We monitored patient visits for two months and found that our workflow bottleneck is entering new patient information into the EHR. We encourage patients to use the patient portal to enter data in advance of their appointment. But they frequently skip it and we end up manually entering data We use an additional medical assistant for patient intake and data entry so the clinical staff can keep moving.
Cross-train staff to fill in when others are out.
Kevin McGrath, MD, FACAAI – Wethersfield, Connecticut
1. Cross train staff to fill in when employees are out.
In small offices, one absent employee can throw off the entire day. Avoid this chaos by training employees to take on multiple roles. An ancillary benefit? It builds team spirit by enabling employees to help each other when needed.
Our MAs rotate between working in clinical roles and serving as receptionists. When one is out, our office manager can cover the front desk and a nurse can cover for the MA. I help the nurses if needed. Nurses can also answer phones and book appointments if the receptionist is overwhelmed. We’re also considering training one of the MAs to bill allergy shot administration.
For more tips on practice efficiency, check out our newly updated Practice Profitability toolkit. We have a wealth of suggestions, including smart staffing, how to take advantage of technology and how to optimize office space to improve workflow.