There are two primary factors within the SBHC’s control that impact the percentage of total available visits completed by provider(s): staff working at the top of their licensure/job descriptions and an effective appointment system.
Example from the SBHC Field
Case Example: Increasing Provider Efficiency Without Compromising Quality of Care
An SBHC program in Ohio completed a workflow analysis. Noting that their providers were spending a significant portion of time on non-clinical activities like preparing students for their visits, as well as helping them in and out of the exam room, they contemplated ideas for increasing provider efficiency without compromising quality of care. Running some numbers to determine the cost-benefit of adding a medical assistant (MA) to the team, the sponsor figured out how many visits would be needed to support the MA. Their calculations proved correct: hiring an MA increased productivity and reimbursement, which more than covered the additional staff expense.
Frequently Asked Questions
Enable each staff member to work at the top of their licensure or job description:
- Assign providers adequate clinical time for patient care and necessary non-clinical time for other responsibilities as required (i.e., meetings, outreach, and administration). Do not include non-clinical hours when calculating efficiency and productivity.
- Conduct an analysis of the activities providers engage in from the time the patient arrives until the patient leaves the SBHC; identify which of their activities are non-clinical and could be reassigned to other staff members.
- Reassign any non-clinical provider activities (e., registration, health history, vital signs, etc.) to other team members (clinical and administrative support staff). This will allow other them to perform at the top of their licenses and job descriptions.
- Prepare ahead of time for next day’s appointments. This allows time to verify current consent and insurance status and assess the need for completion of national best practices for SBHCs: well care visit, risk assessment, BMI, annual depression and Chlamydia screening.
Implement effective appointment systems:
- Develop scheduling protocols for walk-in and scheduled-ahead appointments.
- Simplify scheduling by offering two types of visits to reduce wait times and unused visits: a short 20-minute visit for established patients with acute needs and a long 40-minute visit for new patients, well care visits, complicated health histories, or non-English speaking.
- Determine how many visit slots you need to have available for walk-in visits.
- Add appointment slots during non-school hours if possible to generate more visits, encourage family participation, and reduce the time students are out of class.
- Limit the number of appointments booked more than two weeks ahead to minimize no-shows.
- Implement system for administrative support staff to notify students/teachers when the SBHC is ready for them to proceed to clinic. This minimizes time out of class and unnecessary wait.
- Use text messaging to have patients confirm or reschedule their appointments.