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Improve Medical Practice Performance by Adding Structure

Improve Medical Practice Performance by Adding Structure

Medical office staff is asked to perform both simple and relatively complex tasks. When the organization of the workday requires repeated shifting from one type of work to the other, productivity and reliability suffer.  Introducing some structure to the workday can yield significant benefits.

Consider the front office staff.  They greet patients, make sure patient paperwork is current, monitor account payment status, and do anything else that makes sense in the practice.

Greeting patients is an essentially reflexive task.  The principle requirements are that the greeting be prompt and clearly engage with the patient.  Making sure paperwork is current and monitoring account status can be complex.  It requires understanding practice policies, assessing the patient's file and account, and determining what corrective action is necessary.  Instead of being a single action, it is a process.  Success here depends upon accurately gathering information and applying logic.

When both simple and complex tasks are addressed during the same time frame, both suffer.  An employee engaged in a complex task will be slower to greet an arriving patient, and the greeting will be somewhat distracted.  That is because she is experiencing some difficulty in putting down the complex task — pulling her mind away from the decision tree and trying to stop at a logical place.  Going back to the complex task requires time to reorient herself and get her mind back to where it was when interrupted.  The reorientation requires time that does not advance the task; at best it gets back to the stopping point.  The reorientation is often incomplete or erroneous, and information is lost.  Research indicates that interruptions make a task take 50 percent more time and result in 50 percent more errors.

The solution is to segregate simple from complex tasks.  Giving the simple tasks to one employee and the more complex to another is one way to accomplish the segregation.  While this method appropriate for very complex tasks, it is otherwise not practical.  The better solution is to segregate the tasks in time, e.g., reserve a part of the day, when interruptions are unlikely or can be prevented, for the complex tasks and do not try to accomplish them when interruptions are to be expected.

For instance, separate the review of patient paperwork and account status from the check-in process.  Reserve some time each day to review the patient scheduled for the next day.  Note what documentation is missing or needs to be updated, and note any action required on the account.  That removes analysis and decision making from check-in.  Acting on the notes is almost as simple a task as greeting the patient.

Understanding the characteristics of different tasks is an important part of structuring the workday for maximum productivity and reliability.  It also has a positive effect on both patient and employee satisfaction.

 
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