Practices Modeled After Airlines….Without the Peanuts

September 21, 2010

Looking to reduce costs and improve patient care at your practice? Well look no further than the good folks Southwest, Delta, and even Jet Blue for some ideas from the skies that could help you on the ground.

Looking to reduce costs and improve patient care at your practice? Well look no further than the good folks Southwest, Delta, and even Jet Blue for some ideas from the skies that could help you on the ground.

U.S News and World Report has a great story on a study underway by the Center for Health Organization Transformation (spearheaded by none other than Newt Gingrich) that is looking into whether the airline industry can offer the healthcare industry some tips to lower its bottom line and make its customers happier.

Yep, you read that right, airlines as an expert on making people happier.

Nonetheless, the article looks at using "systems engineering," a staple of other industries, to repair the $2.3 trillion industry, which one of the partners in the center's research says is "riddled with problems." The study, and its authors, note that what works for some will not work exactly the same with healthcare, but it is the concept that is key.

Take for example the use of "checklists" in hospitals prior to surgery or other procedures similar to those done as you are seated in an airplane, the article notes. According to The British Medical Journal, that practice has reduced patient deaths by 15 percent in London hospitals.

Then there is the issue of scheduling, from surgeries to the waiting room of a primary care practice. The Center is simulating patient flow and what it calls "strategic" overbooking where, like an airline, patients/passengers don't always show up when they are supposed to, wasting medical professionals' time and resulting in lost revenue.

A Massachusetts hospital used an overbooking method to first determine which kind of patients were most likely to skip appointments - those coming for an annual exam - and then figured out how much to overbook their services for such days. Essentially, they created a patient "stand by" list, that needed attention only if those patients did in fact show up. The results were not covered in the article, but will likely be revealed in the final study.

Now if you are a frequent traveler or even take to the friendly skies for the occasional vacation, you know - much like your practice - that there are unforeseen circumstances that cause delays, backing up business and creating cranky folks just looking for service.

On the other hand, thousands of flights run each day nationwide without incident, mainly on time and with satisfied customers aboard.

So, if we are going to learn from the airline industry on how to reduce costs and make happier patients, I say let's go all in.

Some initial thoughts: 

Waiting room programming: Pediatricians, you guys are mostly all over this one, but for the rest of you, set up a TV in your waiting room that shows well-edited, under two-hour movies, or just run "Two and a Half Men" on a constant loop.

Get new furniture: Forget those comfortable chairs. Time to enact rows of seating at your practice that are obscenely close to one another. Remember, leg room is a privilege, not a right. But don't let people get up and meander around the place, either.

Snacks: This one can be tricky, given that eating and doctors' visits are usually a no-no, but remember, patients usually come with another person in tow. Target their companion with overpriced food and beverages and please, oh please, give them the whole can of soda and not just a cup with 90 percent ice and 10 percent beverage.

One word – SkyMall: Yep, time to work on merchandising for your practice and perhaps some surrounding local merchants. It isn't until you see an alarm clock that speaks the day and time that you realize you need a clock that speaks the day and time, right? Oh, and get to work on some catchy slogans for those T-shirts, hats, and other items. And don't go with the "I visited Dr. Jones and all I got was this lousy T-shirt," either. Get creative: pediatricians, offer those onesies with your practice Web site on it; orthopedists, what better advertising than a guy with your name on his knee brace at the gym?; cardiologists, you are allowed to go with the "My heart belongs to Dr. Smith" line of clothing ….it's kind of cute.

Patient seat assignments: Thanks to Southwest, feel free to book five patients for 10 a.m. and give them letters A-E; when they arrive, tell them alphabetical order doesn't matter, they all can line up under a sign and be seen in that order. No doubt - like the airport - your 10 a.m. patients will be standing by 9:15 a.m. in your office.

Friendly staff: Not that you don't keep your front staff happy now, but since they are adding new customer service and clean-up services at your practice, treat them well. They need to keep that waiting room fresh between appointment, deal with your patients, and, of course, remind everyone where the emergency exits are just in case. We don't want any JetBlue incidents, do we?

Now these are just some starting points. I fully expect practice administrators to come up with a lot more ideas on how to learn from our friends in the airline industry - feel free to share yours below.

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