Improved Patient Scheduling Enhances Care and Boosts Revenue by $8.3M

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patient accessThe amount of time a patient may have to wait for a scheduled appointment at Texas Children’s Hospital varied greatly as a result of a lack of standardized processes. After taking a deeper look at its scheduling process with the help of analytics, it was able to develop an improvement strategy aimed at improving access to care—enhancing patient care and boosting revenue.

Featured Outcomes

  • $8.3M increase in revenue, the result of adding more than 53,000 appointments annually.

IMPROVING ACCESS TO CARE DRIVES REVENUE GROWTH

Revenue growth is a top priority for health system CEOs. Improving ambulatory access remains a top concern, as it allows hospitals and health systems to better serve patients while improving revenue.1

Texas Children’s Hospital, a not-for-profit organization located in Houston, Texas, is focused on creating a healthier future for children and women and is consistently ranked among the top children’s hospitals in the nation. Improving ambulatory access is key to its mission.

PATIENT VISITS DELAYED DUE TO SCHEDULING DIFFICULTIES

Feedback from patients at Texas Children’s indicated that it was difficult for them to schedule an appointment, often requiring multiple phone calls, and extended wait times. A little over half of the specialties were able to offer new patient appointments within 14-days of referral. However, some patients faced a six to eight-month wait for an appointment.

Practices for scheduling and referral management varied substantially across the organization, with more than 60 different referral workflows. Texas Children’s needed a data-informed improvement plan for access scheduling to ensure the availability of appointments for its patients, which in turn would increase patient satisfaction and drive growth for the organization.

ANALYTICS DRIVES STANDARDIZED PATIENT SCHEDULING

The CEO of Texas Children’s designated patient access as a strategic priority, establishing an access and patient scheduling improvement initiative to address the problem. A steering committee of executive sponsors, physician leaders, ambulatory executives, information services executives, and project managers was established to guide work teams to improve patient access.

The steering committee leveraged the Health Catalyst® Data Operating System (DOS™) platform and a robust suite of analytics applications, including the Practice Management: Patient Access Accelerator, to analyze referral, scheduling, and capacity data, identifying multiple opportunities for improvement.

The organization prioritized improving the referral process, the patient scheduling experience, capacity and utilization, and ultimately financial performance. Physician leaders partnered with operational leaders, generating support to adjust processes to improve the patient experience and access to care by:

  • Optimizing the patient referral process. Texas Children’s streamlined the referral process, using one submission route through a centralized intake team, along with standardized referral content. This decreased the time required of providers to submit a referral, improving the process for both providers and patients. The processes loop is closed by following up with referring providers, ensuring they are aware the referral was received, and a patient is scheduled for care.
  • Allowing for self-scheduling. Texas Children’s provides patients the option to schedule appointments themselves using an online scheduling tool. Patients who prefer assistance with scheduling can contact the centralized call center or use the existing patient portal. Patients can then elect to be notified via text message when an earlier appointment time becomes available with their provider.
  • Increasing capacity and improving care utilization. Texas Children’s implemented a standard template for schedules, consistently scheduling providers to be available to see patients in four-hour blocks. Differing appointment lengths are available during this four-hour block to meet specific patient needs, including “holding” appointment times for complex subspecialty patients. All unfilled complex appointment slots are made available for any appointment type within 72-hours of the clinic date. The organization added weekend appointments, and extended clinic hours.

Texas Children’s uses the data platform and the Practice Management: Patient Access Accelerator to monitor and manage the effectiveness of its clinic operations. The organization can quickly and easily visualize the number of appointments, no-show rates, the amount of time each provider is spending in clinical care, percent of arrived patients, and template utilization. Texas Children’s can visualize the number of appointments in relation to budget goals, quickly identifying when there is a variance, enabling leaders to create an action plan to improve patient access.

RESULTS

As a result of its improvement efforts aimed at improving patient scheduling, Texas Children’s achieved impressive results, including:

  • $8.3M increase in revenue, the result of adding more than 53,000 appointments annually.
  • 12,000 no-shows avoided.
  • 30,000 appointments scheduled online.
  • 39 percent relative improvement in patient satisfaction with ease of scheduling.

“We were prompted as an organization to improve access, and that led us down the path to analytics. Using analytics, we developed a strategy that took advantage of tools such as our patient portal, while also standardizing our referral process to maximize access. This has allowed us to implement solutions to increase patient access and improve revenue by $8.3M.”

– Carrie Rys, Assistant Vice President, Ambulatory Operations

WHAT’S NEXT

Texas Children’s plans to continually make it easier for patients to access its services. The organization is rapidly expanding telehealth offerings to make more services available to patients at the times and locations that are most convenient for them.

REFERENCES

  1. Merritt Hawkins. (2019). 2019 Physician Inpatient/Outpatient Revenue Survey. Retrieved from https://www.merritthawkins.com/news-and-insights/thought-leadership/survey/2019-physician-inpatient-outpatient-revenue-survey/

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