Eyeworld

OPHTHALMOLOGY BUSINESS 154 April 2016 by Corinne Wohl, MHSA, COE, and John B. Pinto Checking for correct staffing at the front desk helpful or an EHR project de- manding attention? 5. Consider labor substitution by a high school student to do routine work, like scanning paper notes into your EHR system or preparing charts for those without digital records. 6. Don't overlook the impact of experience. A small number of highly experienced receptionists can work circles around less-expe- rienced individuals. Every practice develops staffing habits that they feel are entire- ly correct. If you could visit 100 random colleague practices today, you would find some much more "efficient" and lean than you are (to the point of frank customer service deficits), and some that are much less efficient. Take a middle path. Realize that even in the best-run practices, a busy morning clinic can be on the verge of breakdown. Fight the natural urge to throw extra peo- ple at the problem, and help your staff learn to accommodate to their "rush hour" in the same way that restaurant workers step up the pace at lunch and emergency room staff gird themselves for Friday night. Communication is key. Pull to- gether a meeting of the stakeholders —your reception staff, a lead doctor, the head tech, the administrator. Discuss the issues and goals. En- courage new ideas and trial periods to test new ways. With effort and a balanced approach, you can taper practice expenses, increase staff effi- ciency, and provide great customer service. EW This column by well-known authors John Pinto and Corinne Wohl presents a new, easily applied pearl designed to advance patient care, increase efficiency, and improve financial performance every month. "There can be economy only where there is efficiency." –Benjamin Disraeli I t can be frustrating to deter- mine under- or over-staffing in any department. But it is partic- ularly difficult in the reception area (inclusive of check-in, check-out, medical records, and phones) because patients commonly arrive and call the office in waves. At peak traffic the patient re- ception department looks and feels overwhelmed. Staffers there can experience extreme, dual pressure from coworkers and customers. Technicians and doctors are tapping their toes, anxiously awaiting the processing of patients through the front desk so that their work-ups can begin. Patients obviously don't like waiting to be attended to. They may be sweet to their doctor but vicious with the rest of the office staff. There is the added stress of business office staff waiting to pounce on any demographic or insurance data error that is made. No wonder front desk duties are often considered the most challeng- ing and pressured in the office. We utilize 2 broad ways to observe and assess workloads and staffing levels at the front desk. The first is pure, subjective observation. Unlike ophthalmic technicians who are scattered throughout the office, reception staff are often clustered, and you can observe, grossly, how busy or not each person appears to be through- out the day and week. In addition to these subjective impressions of staff efficiency, we also rely on objective analysis. The math is simple. Divide total reception/phone/records staff hours in a month (including paid holidays and paid time off) by the number of total monthly visits (including postoperative exams). Be sure to omit any time that reception staff is spending on non-core duties such as posting charges or performing clerical chores for providers or ad- ministration. In a general ophthalmology practice, we expect to see 0.5 recep- tion payroll hour per patient visit. A few highly efficient prac- tices are able to achieve 0.3 or 0.4 reception hour per visit, but this is difficult to achieve without verging into poor customer service, burnout, and high staff turnover. We periodically see higher figures. It would be reasonable to hit 0.6 or higher in spa-like elective plastics and LASIK centers. But for the vast majority of settings, 0.5 hour of reception time per visit is the correct target. In all of this, you need to strike a balance between providing great customer service and being fiscally responsible. It is important to col- laborate between management and practice owners to strike the right balance. It is perfectly reasonable for an administrator to acquiesce to an owner's desire to provide 5-star service—just as it is reasonable for a thoughtful owner to accommodate an administrator's reasonable con- cerns about trimming overhead. Here are 6 pearls to combat front desk cost-creep and still provide excellent service: 1. Agree on an overall objective target (0.5 hour per visit in most cases), and check on this figure monthly. 2. Shift staff resources up and down to fit traffic, by time of day or day of the week. You probably need fewer staff on a day when surgeons are in surgery or away at meetings. 3. Consider using part-time staff to handle the typical extra phone call demands on Mondays and Fridays, while keeping core staff limited on the lighter days. 4. Shift some staff duties throughout the week to tackle efficiency lags. Do you have project work where an extra set of hands could be Ms. Wohl is the adminis- trator at Delaware Ophthal- mology Consultants. She has 30 years of hospital and physician practice management experience. She can be contacted at czwohl@gmail.com or 609-410-2932. 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 or 619-223-2233. About the author To the point: Simple practice tune-ups for complex times

• Cover