We met with five members of the Ambulatory Capacity Management team—Kim Pacheco, Amy Barrus, Marcie Weiszbrod, Staci Taufer, and Ryan Watts—to talk about their standardization efforts, their improvement benchmarks, and their love of back-end functionality.
In health care, a template is a provider’s schedule
determines the pace of each visit, as well as the number and type of patients a provider is seeing. When Epic first rolled out in 2010, very few employees understood its endless capabilities. That led providers, clinic managers, medical directors, and other front-line staff to get creative with their use of the software, which in turn produced severe scheduling inconsistencies.
Did you know we have an Access Team?
U of U Health's Access Team is a group of functionality experts whose purpose is to make providers’ and schedulers’ lives easier.
Thanks to the access team’s efforts, Epic now makes it easier for schedulers to get the appointment right the first time, removing some of the opportunity for human error. “Clinic staff are the experts in which providers see specific types of patients,” says Marcie Weiszbrod, Ambulatory Access Specialist. “That knowledge must be condensed onto a single piece of paper that schedulers can follow. Anybody who’s worked in a call center or as a scheduler knows it’s stressful work. You have to remember lots of details–for example, three providers in the same specialty do something different–while providing prompt and accurate service to the patient.”
A good template creates better days.
The access team’s work to improve Epic allows schedulers to automate certain criteria: visit type, patient type, appointment length. The team also works with individual providers to create a smoother schedule that allows for downtime. Recently, they worked with a new OB/GYN provider who complained of an erratic schedule: some days were spotty, while others were overwhelming.“ On a good day, she had three return OB patients, whereas on a bad day, she had five new GYN patients all scheduled back to back,” Weiszbrod says. The team programmed a limit of new vs. return patients that allowed the provider to grow her patient volume while spending the time she needed with each patient.
Reducing clinician burnout was what Director Kim Pacheco had in mind when she built the access optimization team. “When we meet face-to-face with a provider to talk about templates, we’re on their side,” Pacheco says. “If their template ends at 5:00 PM, we wonder how we can get them home so they can have a life outside of work. Once the provider understands the back-end functionality of Epic, it sparks creativity for new ideas, too: ‘What about this group of patients? Is there a way we can make their experience better?’”
Before the team worked to improve templates, Ambulatory Access Specialist Amy Barrus says the most common remark they heard was, “Don’t touch my template!” Now, providers understand the benefits of a team to support. Barrus tells providers, “Don’t try to build the system functionality yourself—let us build it for you. We can improve your schedule so that you can achieve your goals.”
Four key components of template optimization:
1. Find yourself overbooked? Reflect reality.
“Reality is always our goal,” Kim Pacheco says. “Don’t just build a template for the sake of building it. That’s how you get overbooked or double-booked, or end up seeing one patient for an hour and another for only 15 minutes. Your template should reflect the reality of your day. If you don’t arrive until 9, don’t open your template until 9:15. If you have a meeting every Monday from 8:00 – 12:00, block that out from the beginning.”
2. Use the system functionality.
“There can be more than one visit type per session per provider,” Ryan Watts says. “If return patients get 40 minutes instead of 60, make that a specific visit type. If a post-surgical follow-up usually lasts 20 minutes, standardize it. That way the scheduler doesn’t have to wonder what duration to use with different visit types.”
3. Build in breaks.
“Every staff member and every provider needs to eat lunch and use the bathroom,” Amy Barrus says. “Building in breaks means you’ll be ready and refreshed for the next session of patients. It also creates a buffer if you or your staff gets behind.”
4. Create a baseline for standardization.
“We like to do 240-minute or four-hour sessions,” Marcie Weiszbrod says. “That creates predictable schedules for providers while increasing access for patients.”
The Access Team’s advice for new providers:
A one-size-fits-all solution doesn’t exist.
The access team works with new providers to build a template that can adjust as they get more comfortable. “We’re not setting these templates in stone; you won’t have to use them for the rest of your career,” Barrus says. The access team will help establish a template with longer blocks of time and then reduce appointment times to a more realistic clinic flow.
Keep your access as open as you can.
“Keep your access as open as you can,” says Ryan Watts, Ambulatory Access Specialist. “If you’re waiting for the perfect patient calling for a perfect time slot, it’s difficult to fill your schedule. Our advice is to hold slots for particular types of patients for a set time, and then open them up to different patients or visit types.”
Get to know your scheduling staff.
Consider visiting the call center or schedulers to meet them. Your scheduling staff is the first contact a patient will have with you. It begins to set patient expectations about your office: how easy it is to see you, how responsive you are, etc. “Let the schedulers put your face and your name together,” Weiszbrod says. “Tell them a few things about yourself. That creates a personal connection with your scheduler, who can build a connection between you and that patient you haven’t even met yet.”
Don’t go it alone–use the team.
“Don’t go it alone and try to become a template expert yourself,” says template optimization team manager Staci Taufer. “We’re here—you can rely on us.”