Eyeworld

EW NEWS & OPINION 28 March 2016 What should you do if these 3 audits indicate a gap? There are several easy interventions: • Try to identify and correct the heart of the problem. Is a young- er doctor under-supervised and misnominating the RTC order? Is an older, overly busy doctor pushing out return visits to keep from clogging his schedule? Are scribes failing to complete the re- cord with the return order? Is the front desk failing to make a return appointment or defaulting to the lazy expedient of saying, "Don't worry, we'll just send you a card." • At the end of each day, use your practice management system to assure that every departing patient was either reappointed, put in the recall system, sent to a subspecial- ist, or sent back to their referring doctor. • If the third audit, examining old charts (manually or by data min- ing), shows a significant backlog of lost patients, muster a staff task force to reestablish contact with calls, emails, letters, or all 3. • Until your recall error and omis- sions rate declines, repeat the second of these 3 audits monthly. • Excess patient attrition can indi- cate not just clerical or medical gaps, but also patient satisfaction problems. If you suspect this in your practice, conduct patient sat- isfaction interviews by phone (the subject of a future column!). EW by John B. Pinto and Corinne Wohl, MHSA, COE • Based on each patient's age, diagnosis, and insurance plan, was the return-to-clinic (RTC) interval appropriate? • Did the patient receive an ap- pointment at checkout up to 1 year out? (This is vastly prefera- ble to sending a recall notice.) 3. Electronically or manually pull 5 charts per provider of patients last seen 2 years ago. Examine each patient record. What portion of these patients were lost to follow- up? Don't be surprised if your error rate is high. In the average practice we typically see a 20+% error rate the first time such audits are per- formed and before corrective actions are taken. Closing any recall and continuity of care gaps that you find will not only improve patient care and improve practice collections, it will also reduce the risk of malprac- tice exposure from failure to follow up with significant eye conditions. Auditing for recall gaps is a breech in good recall hygiene. Here's how you can do 3 simple check-ups on this cornerstone of great practice management. 1. Count up the number of estab- lished patients you have seen in the past 12 months, and com- pare this figure to the number of established patients in the prior 12-month period. In a general, geriatric practice you should find a 5+% increase each year—a figure lower than this means you are bleeding out patients. Subspecial- ty, referral center practices will typically see a slightly lower pace of established patient growth. 2. For each provider in your practice, pull the records of 5 patients seen in the past month. Dive into the charts and your practice manage- ment system's appointing records and determine: • Does the chart indicate a spe- cific return appointment order? (Not "PRN" unless the desire is to dismiss the patient.) This new column by well-established authors John Pinto and Corinne Wohl will present a new, easily applied pearl designed to advance patient care, in- crease efficiency, and improve financial performance every month. G reat healthcare for patients and great financial health for practices don't always go hand in hand. Taking time off for added training or keeping up with clinical technol- ogy almost always ding the bottom line, even if they do improve patient services. But here's a prominent excep- tion: Continuity of patient care is at the heart of good medicine—and coincidently, it's also at the heart of good business practices. So there is no better place for us to dive in with this new EyeWorld column than to pass along 3 simple audits your staff can conduct in just a couple of hours. The single most common cause of faltering financial performance Ms. Wohl, administrator at Delaware Ophthalmology Consultants, has 30 years of hospital and physician practice management experience. She can be contacted at czwohl@gmail.com. Mr. Pinto is president of J. Pinto & Associates, an ophthalmic practice management consulting firm established in 1979, with offices in San Diego. His latest ASOA•ASCRS book, Simple: The Inner Game of Ophthalmic Practice Success, is now available at www.asoa. org. He can be contacted at pintoinc@aol.com. About the authors To the point: Simple practice tune-ups for complex times

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