In this guide, ASC and practice leaders will discover when using surgical scheduling software makes the most sense, key features to look for, and tips for ensuring the best ROI. Read the guide below or enter your email to download your copy to take on the go.
Each year, surgeons and practices are pressed to do more with less. Insurance companies continue to add more hurdles to secure surgery authorization, and medical staffing shortages place an increasing administrative burden on teams. Canceled cases, poor communications and late or inaccurately ordered supplies are almost inevitable in such circumstances. And these are just a few of the problems caused by surgical scheduling processes that are stuck in the past. But such challenges can be ameliorated if not eradicated with the right scheduling software. With artificial intelligence (AI)-powered solutions built for the 21st century, many practices discover they can improve operations with:
An efficient surgical scheduling process significantly enhances both the quality and cost of providing care.
Many leaders at ambulatory surgery centers (ASCs) and surgical practices are recognizing that the status quo of managing surgical schedules is no longer enough. Some of it is a volume issue. Outpatient surgery in the U.S. is projected to grow to 144 million cases (or $1 trillion of the market) over the next year. At the same time, the landscape is increasingly challenging. Declining reimbursement, staffing shortages, and administrative bureaucracy continues to add stress around the delivery of this care.
Given this difficult environment, many healthcare providers are recognizing the need for greater efficiency, productivity, and less friction in day-to-day processes. By abandoning old static EMR intake forms or a hybrid approach with paper-based posting sheets processes, practices can break down information silos and, as a result, increase patient flow and reduce demands on staff time.
The need for automation is a rather nuanced challenge. Understanding root causes can help organizational leadership better understand what to look for when considering the best choice for their needs.
Surgical schedule pain points at many organizations are founded in the nuts and bolts of scheduling—forms, processes, and communication channels. Below are some traditional trouble spots for practices and ways automation can present opportunity for improvement.
Too Much Depends on One Person
A frequent problem in many surgical scheduling processes is that too much management depends on the knowledge of one role: an over-extended scheduler. Traditionally, schedulers have served as the primary source for managing information flow to almost every stakeholder in the operating room (OR) and are expected to know what happens when, where, and with whom. The way this information is managed also presents challenge. Many schedulers keep key details in their working memory: which rooms have which equipment, how the site procedures are grouped in which OR, and so forth. Such a system naturally results in unnecessary levels of worker stress, errors, and inefficiencies.
With AI-powered software, transparency and information sharing for better decision-making is enhanced. Electronic forms and real-time, shared communication processes demystify the highly specific knowledge schedulers possess, which means the scheduler’s physical presence is not always required to provide clarity.
Another area that traditionally presents challenge is how information is stored at time of surgery. All too often, a physical wall magnet or electronic board is the source of truth for the scheduling of multiple ORs. When data lives in one physical place like this, changes are only seen there, or, worse, not at all.
Implementing a shared, real-time surgery scheduling software interface has a unifying effect on the entire OR team. A web-based program enables real-time communication wherever needed. Automations can be set up to email or text relevant stakeholders with assignment changes. In addition, software that works not just on the day of surgery, but in advance, can help ensure block time is optimized. The right technology will even make recommendations to improve scheduling efficiency.
Physician Stress and Paperwork Fatigue
Physician time also isn’t optimized with traditional systems. Physicians spend an average of 15.6 hours per week on paperwork and administration—time that could otherwise be spent on focusing on the business and patient care. According to OR Manager, a common source of frustration with traditional scheduling processes is that actual procedure description used by the surgeon may not be accurately reflected by the surgery facility descriptors. Also, the scheduling codes may not accurately reflect the case being performed. Inaccuracies such as these are often resolved only when surgeons have access and visibility into the process and can add to physician stress leading up to the surgery.
Electronic forms can capture the diversity of cases and needs of each surgeon much sooner. A point-of-care scheduling tool allows real-time notes to be added and shared with others to accommodate changes. As a result, the surgeon can share vital information and preferences with PACU [post anesthesia care unit] staff, nurses, equipment vendors, and schedulers at the outset of scheduling.
Coordination of communication is important with third parties as well, as it can affect things such as whether the right equipment is ready and if insurance clearance is complete. With scheduling software, the procedures used to communicate with third parties—such as insurance companies, referring physicians’ offices, and equipment vendors—can be automated and streamlined.
Patients Can Be Unpredictable and Hard to Reach
Although patients are sometimes the “wildcard” in the scheduling process, evidence shows that no-shows and delays can be improved dramatically with better patient communications up-front.
According to an article in Risk Management and Healthcare Policy, endoscopy no-shows can range from 12% to 24%. The author states “Forgetting about the appointment, patient scheduling conflicts and miscommunication were found to be the most common causes of patient no-shows in various healthcare settings.” The same study cited previous research in which no-shows were reduced from 20% to around 7% simply by using pre-scheduled telephone reminders.
Surgery scheduling software automates patient messaging through email, text, or phone, depending on the patient’s preferences. Receiving read receipts will give staff insights into the patient’s level of engagement. Technologies also are changing to make these communications more personalized not only around type of procedure but physician preference and individual patient risk factors, further enhancing importance in pre-surgery education and engagement.
Although surgery scheduling processes can vary a bit among organizations, most tend to experience the same types of challenges at various points. Some of the most common issues that lead to unnecessary delays, miscommunication, and errors are noted below as well as ways an automated system can be useful in tackling them.
In many healthcare facilities, the reliance on paper forms or emails makes it difficult to know where overall responsibility for case management lies. Edits to surgery schedules or other crucial information may not be received by every stakeholder involved in the procedure.
Transcription errors can occur when notes are handwritten. These errors not only cause frustration and potential delays to surgeries, but they can also have a negative impact on the care being delivered. Tracking down the source of errors also generates an increased workload for the scheduler, who will have to identify and resolve the error.
Incomplete forms, missing patient information, and other mishandled details commonly create problems, from reduced efficiency and profitability to unnecessary delays and even cancellation. Compounding the problem, when surgery is rescheduled because of missing information, the scheduler must contact all parties by phone to relay the change.
Many practices and ASCs rely heavily on their surgery scheduler, and an unexpected absence of this individual can bring the entire OR to a halt. Meanwhile, schedulers juggle a mammoth workload. In addition to keeping every stakeholder current on progress of cases, the schedule must also ensure patients receive pre- and post-surgical education, coordinate presurgical clearance, verify insurance and preauthorization, and coordinate surgical supply preparedness.
1. You’re Constantly Chasing Paperwork
Lost or misplaced consent forms alone cost hospitals, on average, $580,000 per year, according to research from Johns Hopkins. In an astonishing 66% of surgeries, patient consents are missing, resulting in delays to 10% of all surgical procedures. Furthermore, information gaps can be a legal hazard. Cynthia D. Grimes, JD, senior counsel with San Antonio’s Clark Hill law firm, claims consent issues arise in half of all medical malpractice claims.
2. You’re Overwhelmed With Administrative Tasks
According to Medscape, 84% of physicians spend between just 9 and 24 minutes with individual patients. And with more manual paperwork comes a greater the potential for inaccuracies. Handwritten paper-based forms have been shown to have error rates of up to 50%. Being able to share a unified, automated view of pending, scheduled, completed, held, and canceled surgical cases facilitates collaboration and minimizes the need for rework.
3. Your Block Time is Overbooked and/or Underutilized
If the ASC or practice can’t fill the block with cases, its OR use will lose money at a rate of, on average, $62 a minute. This is an area where surgery scheduling software can really help schedulers—and physicians—closely monitor how block time is used. By supplying extensive data on block time use and trends, scheduling software can identify bottlenecks, correct inefficiencies, and optimize OR use over time. An intelligent operating room allocation tool can integrate institutional, surgeon, patient, and case-specific scheduling requirements to make optimal case scheduling sequences easier and even make recommendations that can drive more surgical volume.
4. Surgery Delays and No-Shows are Commonplace
Using surgery reminders and other automated notifications and prompts to improve communications with patients can reduce the likelihood of no-shows and cancellations due to missing or incomplete paperwork. A study in the Journal for Healthcare Quality shows that replacing static EMR intake forms or a hybrid approach with paper-based posting sheets with an electronic system reduced scheduling errors to just 0.5%, and post-op no-shows from 8% to 1%.
5. You’re Receiving Negative Patient Feedback
Poor document management often leads to patients who are dissatisfied, confused about their appointments, unclear about readiness steps, and/or unsure whether insurance communications are aligned. Positive patient feedback is critical, especially when negative reviews can significantly impact a provider’s public image and possibly ratings-based standing in networks. Here, too, employing technology can be useful. A recent study in Telemedicine and e-Health found that communication and convenience were key satisfaction metrics for patients in both remote and in-person settings. Surgery scheduling software can make it easier for patients to disseminate their medical history, preferred surgery dates, or primary physician contact information across the care team to reduce the amount of repetitive data entry required of patients.
In ASCs and surgical practices, staying on top of information management is a constant exercise in multitasking. Given the many pieces and high stakes involved in day-to-day operations, it’s crucial to avoid errors. Effective risk management requires care teams to have a clear idea of where those risks lie. In many instances, removal of manual processes and automation of workflows can create safer more productive processes.
When it comes to surgical scheduling, one small detail falling through the cracks creates a domino effect that negatively impacts all aspects of the organization. What’s more, surgical schedules rarely go as planned. Emergency cases happen, and surgeons don’t always know in advance what procedures will be required.
Let’s look at why managing OR and ASC schedules is challenging and what care providers can do to reduce likelihood for unplanned cancellations and delays and best prepare for the unexpected.
Block Scheduling PredictabilitySchedule variability makes managing block time and coordinating ever-changing details difficult. Schedulers must factor each surgeon’s pace for different procedures, while simultaneously responding to add-on cases and non-elective surgeries. Surgery scheduling software can address these challenges by allowing physicians to fill gaps in block scheduling and release block time they can’t use. The system updates in real time so schedulers can accommodate add-on cases and increase the number of procedures an OR can handle each day. Surgery scheduling software can also track OR activities and analyze data to provide insights into each surgeon’s utilization rate.
Case-Mix VariabilityGiven the inherent variability of case mixes, it is difficult to predict how much time surgeons need for each step in a procedure. Budgeting too much time will lead to under-utilization, but blocking too little time can cause back-ups in the OR schedule. Surgery scheduling software minimizes that uncertainty by analyzing case-specific risk factors. For example, it can identify patients who would benefit from specialist pre-operative clearance before the day of the surgery, as well as cases more prone to complications that will require extra time.
Procedure Types and Physician PreferencesRelying too heavily on individual schedulers’ knowledge of surgeon preferences—for example, specific supplies or equipment—can create bottlenecks in the scheduling process. Furthermore, errors in meeting physicians’ requests often lead to delays, and even cancellations, that add to the OR’s operating costs. Surgery scheduling software with a HIPAA-compliant intelligent repository learns each surgeon’s case preferences. The care team can easily communicate and retrieve information to ensure that every procedure can start with the supply and equipment preferred by each physician.
Last-Minute Schedule ChangesLast-minutes changes in OR schedules are unavoidable, but their impact is always significant, especially when real-time communication with all stakeholders isn’t automatic. Surgery scheduling software with an integrated dashboard and intelligent OR allocation tool gives schedulers the ability to respond to changes quickly. Automated notifications update the right people about changes to coordinate all the parties involved in each surgery. to add-on cases and non-elective surgeries.
One of the biggest risks to not managing surgical scheduling effectively is financial. Every year, ASCs and other healthcare practices lose thousands of dollars to surgery scheduling errors. A study by Tulane University found that every canceled surgery costs an average of $7,100. So, what can busy ASCs or hospitals do to avoid running into costly surgery scheduling mistakes?
To start on time, every surgery requires that the necessary documentation and equipment is in place beforehand. When information is handled via a single, unified surgery scheduling system, missing information or scheduling problems can be identified and addressed far in advance. In fact, more advanced platform can use pervious data patterns to predict what a surgeon will need and how long a surgery will take.
Every aspect of the medical profession deals with massive amounts of “paperwork.” Surgery scheduling software can radically reduce the amount of repetitive, tedious form-filling required to prepare for each surgery. From posting sheets, to insurance forms, to disability paperwork, and clearance requests, AI-powered scheduling systems can automatically generate these forms, giving back much needed time to the team.
Many ASCs and other surgical practices rely on surgical preference cards to make sure that all the supplies, instruments and equipment are in place for a specific procedure done by a specific surgeon. These cards act as a checklist for the surgical needs of the procedure. However, their usefulness depends on how well they are managed—and unfortunately, they are notoriously difficult to keep current. Surgery scheduling software with a cloud-based data repository can keep track of the nuanced preferences for every surgery permutation.
When assessing surgical scheduling processes, leadership will quickly realize that some areas present compliance and safety risks far more than others. Below are the three most common areas of vulnerability.
The 1996 Health Insurance Policy and Accountability Act (HIPAA) protects patients’ medical records and personal health information (PHI). All HIPAA-covered organizations have a duty to collect and store that information safely—a challenge for any healthcare organization. But when schedulers are working with a paper-based system, it’s even more daunting.
Despite the widespread adoption of electronic medical records (EMR), much of the surgery scheduling process still takes place with paper and pencil outside the EMR. Everything must be captured, recorded, and disseminated accurately, and all the required surgical support—admission documents and anesthesia plans, clearance instructions, and preoperative orders—must be secured for the required period and then properly disposed of.
To be compliant with HIPAA, healthcare providers must do more than just avoid data breaches. Providers can be penalized and fined $100 to $50,000 per violation for not having the required technical, physical, and administrative safeguards in place.
A HIPAA-compliant, cloud-based repository can provide a centralized location for essential forms, including pre-authorizations, doctor preference cards (DPCs), and patient surgical assessment forms. Systems with these capabilities allow surgeons and schedulers to access data from anywhere securely.
Surgical teams communicate as many as 150 data points for one surgery. They also coordinate information from multiple stakeholders, track potential conflicts, and identify and reserve equipment—all on schedule. When paper-based systems depend on hard-to-decipher hand-written notes to capture patient details, clinicians leave themselves open to inefficiency, errors, and non-compliance.
Even with email or tasked-based systems, considerable manual transcription is required, with the potential for missing or incorrect data. Not only does poor data handling hamper efficiency and therefore profitability, but it also makes the organization vulnerable to litigation.
Advanced surgery scheduling software that automates notifications, documents patient records, and eliminates legibility issues can alleviate the risk of costly errors.
When scheduling information is siloed in paper posting forms, schedulers cannot collaborate or share their work. Not having the right information at the right time can lead to unnecessary delays, cancellations, or inaccuracies. Furthermore, updating records or processes quickly becomes a time-consuming endeavor to make sure everyone is up to speed.
With paper-based systems, schedulers spend about an hour to schedule just one surgery—and last-minute changes can derail the entire schedule. At some level, paper-based systems can even hurt the overall business by hampering information exchange with other locations or surgeons.
Digital tools allow the surgical team to seamlessly collaborate on a case schedule even when the scheduler is absent or offsite. An integrated dashboard that tracks pending, scheduled, completed, held, and canceled surgical cases with their supporting information in one central and accessible location improves workflows across the board, preserves business continuity, and lessens opportunities for error in absence of the scheduler.
Recognizing the need to move away from manual and paper-based systems is one thing, but implementing changes needed for improvement is another. As practice leaders examine automation options, key is recognizing where surgery scheduling efforts currently are in greatest need of attention, identifying system options and revaluating processes.
Although it is unavoidable that surgeries will periodically have to be canceled, most cancellations are avoidable. Understanding how and why cancellations happen is key to avoiding them when possible.
Scheduling ErrorsIf an ASC or hospital relies on manual data entry, transcription of incoming fax, or handwritten notes for scheduling, then some errors are inevitable. Inaccuracies in surgery timing, procedure codes or equipment preferences/conflicts are bound to occur. Access to clear and up-to-date accurate information is vital, so that surgeons, schedulers, and coordinators can review surgery schedules in advance, confirm what supplies are needed and identify any potential conflicts beforehand. Mechanisms and information must be available to easily backfill slots when last-minute cancellations occur.
Poor Pre-Op PreparationA study of more than 15,000 delayed cases found that the two top reasons for case delays were:
Poor Document ManagementMissing signed consent forms, incomplete paperwork, and data discrepancies are also causes of delays and cancellations. This risk is heightened in ORs that rely on paper-based or handwritten systems. Using intelligent surgical scheduling software makes sure that all the necessary forms and documents are present, correct, and accessible can minimize the likelihood of error.
Patient-Side IssuesAn essential step for avoiding cancellations is to ensure that patients are fully informed and prepared for surgery. If patients or their families are unsure about the procedure or perhaps have not followed the preoperative instructions correctly, it can cause delays or even cancellation. AI-enabled automated notifications can deliver patients with essential information specific to their case without taxing overstretched staff. By providing patients with case-specific, surgeon-specific education, the care team can best ensure patient compliance with any pre-surgical preparations needed.
Cancellation ReductionIn an 8-month study of 5,929 surgical cases, 4.4% were canceled day-of. Among those canceled, 71.6% were judged as potentially avoidable. Potentially avoidable cancellation causes often include:
Turnover Time MinimizationTurnover time in ORs is largely controllable: It’s simply a matter of wheels out to wheels in for the next case. The predictable variability occurs based on different cases, their equipment, and clean-up needs. Experts suggest room turnover averages 25 to 35 minutes but can be as low as 12 minutes. To truly optimize turnover time, cases should be well managed and organized in the days leading up to surgery. Turnover challenges are based on factors that affect room setup and readiness:
Block scheduling assigns operating rooms and resources to specific surgeons or surgical teams for predetermined blocks of time in the surgery day. This approach can maximize OR efficiency and cost-effectiveness, both by filling up the schedule as much as possible, and by reducing equipment and positioning changes between cases.
Because surgery time costs around $1,000 an hour in staff and equipment, administration, and overhead costs, managing block time effectively is a critical way to protect the bottom line. Here are some key questions to help assess block time efficiency:
Also key is tracking and monitoring block utilization. Are administrators monitoring block utilization and achieving the industry goal of 75-85% utilization? Block scheduling ensures that each specialty can consolidate cases on one day (or any smaller block unit) to maximize efficiency and resources.
Many practices find it difficult to reign in wasteful blocks because the surgery scheduling process is shrouded in mystery. However, the following steps can help administrators focus on what is most important.
Too often, surgeons’ offices fax handwritten notes that are scanned and uploaded manually into the OR system. An advantage of scheduling software is that it can automate communication about patient demographics, insurance, procedure information, and special instrumentation.
Why would a block not be accurately filled? Most surgeons underestimate total case duration because of the complex perioperative factors involved. To further complicate the scheduling picture, some surgeons calculate their times differently—time in the room vs. just surgical time. Surgery scheduling software supplies estimates to all stakeholders, making the scheduler’s knowledge transparent to all.
Open time is critical for managing emergent cases and padding against unforeseen schedule changes; in fact, some experts recommend 20% of time be given to an open block. Surgery scheduling software can create one place for surgeons to be made aware of open time and submit requests. The software can also help enact a fair way of deciding which cases gain priority.
When examining processes, those contributing to on-time starts should be of particular attention. The cost of lost OR time runs at about $62 a minute, so wasted time is wasted money. A late first case start will have extensive impacts for the rest of the day, leading to a “cascading effect,” with progressively later starts for subsequent surgeries, and cost the OR even more if overtime is incurred. Most importantly, the quality of care that patients receive can be negatively affected.
Following these steps can go a long way toward improving on-time starts.
It might seem obvious, but make sure that everyone knows what is meant by “start time.” As part of that discussion, point out the importance of starting on time from a cost and efficiency perspective, in a positive way. Many practices hold weekly team meetings, or daily huddles, as a way of keeping on top of scheduling. Documenting and communicating issues via the surgery scheduling platform also helps the team problem-solve and preempt potential problems to keep the schedule flowing.
Part of practice efficiency is ensuring staff time is used most effectively. Recognizing ways to reimagine the scheduler role can often lead to significant productivity improvements and improved employee satisfaction.
To understand role dynamics, it’s useful to examine typical responsibilities and knowledge base.
Surgery schedulers are at the foundation of a well-run surgical practice. Schedulers communicate with surgical facility staff, office staff, supply chain managers, surgeons, physician extenders, anesthesiologists and administration. They are expected to deliver and obtain accurate information, set expectations, and remain calm amid changes.
Surgeon Schedules. The first communication hurdle is working the surgery into the surgeon’s schedule. Based on their insight and available resources, the scheduler must maximize the surgeon’s limited OR time and optimize case sequences. Access to historical scheduling data may help them.
Managing resources to maximize a surgeon’s throughput can be a daunting challenge. Otherwise-competent schedulers may be overwhelmed by the chaos of manual or paper processes often involved in coordination of the many associated parties. Understanding the impact of each surgeon’s requirements on total surgery time ultimately requires countless phone calls to double check information and communicate changes.
Today’s software solutions are better than ever because they offer a real time interface that can wrangle all the paper processes and information conveyed by email, text, phone, or fax.
Patient interactions. The second communication challenge that faces schedulers has to do with patients. Consider the routine points of contact with the patient as described by Washington Orthopedic, an ASC.
Despite this patient interaction, schedulers still deal with no-shows, surgery time overruns, and miscommunications. What makes a scheduler unique is that they maintain composure and awareness when the schedule begins to derail. Software can help them deliver their time and energy to where it matters most.
Block scheduling became popular because it offers surgeons a predictable schedule and autonomy in managing their caseload. Administrators of surgical facilities, on the other hand, push their OR to optimize utilization rates. When rates are pushed too high, there is no flexibility for cases that have unforeseen complications. But when rates are left too low, some surgeons who are performing higher may have to backlog patients, while other blocks of time are unused.
Thus, schedulers must understand that certain cases and specialties have longer surgery times and greater variability and unpredictability in requirements. This insider knowledge is critical. Equally important, schedulers must learn the personal preferences of each surgeon, such as sequencing, equipment, and preferred staffing, that affect the variability in the case sequence.
Surgery schedulers are an irreplaceable talent for an OR, as their ability to communicate accurately and apply knowledge under pressure takes years of experience. Eliminating manual processes is the best way to let them work more happily and more effectively. Their finite energy can be applied to growing the practice rather than just fighting against the tide of inefficiency.
With so much responsibility resting on one person’s shoulders, it’s not surprising that burnout among schedulers is common. In fact, fewer than half of surgery schedulers (48%) last more than two years in their position.
When a surgical scheduler suddenly needs time away, or worse, hands in their notice, it can leave an organization reeling for a bit, as the practice must take on the costs of not only finding a fast replacement but also managing lost productivity while getting someone new up to speed.
Given this dynamic, it’s important for practices and ASCs to support their surgical schedulers both to prevent burnout and reduce turnover. The following workflow actions are vital to reducing stress on staff, preserving business continuity, and improving overall scheduling efficiency.
Cross-Train for the Scheduling Function
When medical practices rely on one person’s skills and intuitional knowledge to manage complex workflows, it not only puts undue strain on that individual but the daily functions of the practice suffer in the event of an unplanned absence. Training a wider pool of staff to handle surgery scheduling creates a safety net and provides flexibility in the scheduler’s day, which has been shown to improve job satisfaction and reduce attrition.
Having an automated, intuitive, and transparent system with standardized scheduling workflows flexible enough to accommodate the nuances of several different surgeon workflows can make cross-training easier, lessen the burden on new schedulers, and ensure greater consistency of process.
Centralize Document Management
A centralized, HIPAA-compliant repository is important for improving access to and tracking progress of consents, referrals, durable medical equipment requests, and insurance prior authorization forms. Having the relevant information readily available to those who need it in real-time not only improves efficiency but also minimizes information gaps that can lead to unnecessary back and forth with the scheduler.
Improve Processes Around Procedural Descriptions and Preferences
Physician preferences shouldn’t rest solely on the scheduler to track. By using scheduling software with systematic and standardized procedural descriptions, surgeons can enter data much more easily, and at the same time reduce the burden on others to decipher handwritten notes. Eliminating this guesswork makes it easier for new schedulers to get up to speed and decreases the chances for miscommunication that can lead to errors.
Use Progress Tracking and Alerts
It can be difficult to keep track of and manage all the communications that go into scheduling just one surgery, let alone dozens of others. Often, schedulers are so overwhelmed that they are only satisfying the bare minimum needed to get a surgery scheduled. Real-time surgery scheduling programs with built-in alerts can help schedulers stay on track, prioritize efforts, and be more agile in their decision making as dynamics change.
Minimize Need for Manual Repetition
A scheduler’s time is often taken up with administrative tasks that are repetitive, such as entering the same patient data on multiple forms, making similar calls to alert clinicians of document needs, or responding to patients’ frequently asked questions. Practices can maximize schedulers’ time—and reduce opportunities for error—by implementing digital forms with autofill options. In addition, AI-enabled Virtual Patient Guides can proactively head off many patient concerns by providing personalized information to help best prepare them in advance of their procedure.
Create a Retention Culture
To retain surgical schedulers, one of the most crucial things a provider can do is to let them know that they are valued. But building a supportive working environment amounts to more than having the back-up staff and workflows in place to take the pressure off them. It’s about the human factor.
Communicate with staff regularly about key achievements. Encourage patients and service users to rate and comment on their experience, and make sure to celebrate the positive comments received. Enable staff to see a progressive path by providing them opportunities to develop their skills and career interests. Take the time to look at where the stress points for the scheduler can be eased with practical changes and technology support to best position the organization for long-term success.
To this point there has been some mention of the importance of patient readiness. The following dives into these dynamics with more detail and explores key aspects of communications to keep in mind.
Surgery scheduling is open to inefficiencies when support teams must juggle multiple surgery types while managing on-the-spot delays and cancellations. It’s no surprise then that back-and-forth communication—between surgeons, staff, and patients—can be one of the biggest minefields for practice operational efficiency.
Consider the following dos and don’ts for successful pre-surgical communications with patients.
Though no-shows may seem like a patient-side issue, the main causes of missed appointments include miscommunication, scheduling clashes, and the patient simply forgetting about the appointment.
To reduce the likelihood of no-shows, practices should adhere to the following communication approaches.
Communicating Patient Information
Communication is also vital in ensuring that patients are fully informed and prepared for surgery. Issues such as language barriers or cognitive impairment, uncertainty or confusion about the procedure, or even just preoperative nerves can cause delays, cancellations, or even no-shows.
Not only do missed surgeries cause problems for healthcare providers and surgery schedulers, but, of course, missing surgery is also bad for the patient’s health. Considering that patients miss between 5 and 20 percent of surgery appointments, it’s quite a frequent problem—and often, it’s the result of patients simply feeling reluctant.
Fortunately, schedulers and other members of the care team can take steps that build patient confidence, positively affect communication and minimize disruption from those at greatest risk of cancelling or not showing.
Provide Case-Specific, Personalized Education Following the Initial Meeting
Although the surgeon may spend time carefully discussing a particular procedure, patients may retain little from the clinical encounter. Providing case-specific information for the patient as soon as they leave the office gives confidence in the process and information to guide their discussions with family.
The reluctant patient is likely to have questions about their own specific case, so avoid generic information. Make sure that patients have all the information they need ahead of time, especially any special arrangements or instructions.
Patients often need to take key steps to prepare for a surgery, such as possibly limiting food and drink, ceasing use of certain medications in advance, taking special steps with washing and/or shaving, and arranging for transportation or packing for a hospital stay.
If patients don’t receive or understand these instructions, at best they may end up calling the surgeon’s office with questions. This means staff will need to search the patient’s history and procedure information, and then contact a busy surgeon so they can share instructions with the patient. At worst, the patient may arrive on surgery day unprepared—potentially creating a situation where the surgery is cancelled at the last minute.
Avoid Frequent Cancellations and Schedule Changes
Poor surgical scheduling data management, missed clearances, or delays in authorization frustrate patients and can fuel apprehension. Surgery scheduling workflows that keep both patients and staff engaged in the lead-up to surgery will be beneficial for both patients and the practice.
Send Appointment Notifications
Studies show that simple phone or SMS reminders can avoid two-thirds of no-shows. Ensure that patients receive a timely reminder of their appointments, with personalized push notifications to their case, in their own language.
Know the Patient’s History
The risk of no-shows or cancellations can often be predicted from previous patient behaviors, such as noncompliance with clinic visits or other procedures. This history can show when a reluctant patient may need specific outreach to improve the likelihood of their attendance. Understanding which patients are disengaged and not consuming educational content or reminders can help busy staff focus on patients at highest risk of cancelling or rescheduling.
Schedule Surgeries with Patient Dynamics in Mind
Scheduling timely pre-assessments and sending reminders to patients can increase attendance. Schedulers can sequence surgeries more efficiently by scheduling patients at high risk of no-shows later in the day to limit the impact on other procedures.
Some technologies make successful patient communications easier than others. The following advances help provide a meaningful and supportive care experience for patients while ensuring the greatest likelihood for surgery readiness without overburdening staff.
Patients are often overwhelmed with packets of generic instructions they receive in the clinic. But with AI (Artificial Intelligence) software, a surgeon’s office can make use of pre-formatted material and then, using rule-based workflows, automatically deliver relevant educational components in the combination needed for the individual patient, including the use of personal YouTube videos.
The best communications are those that occur exactly when needed. Through scheduling software programs, patients are added to a communication pathway as soon as a scheduler registers them for surgery. Predictive text cues will then push reminders, encouragement, and more to patients on a timetable personalized to their surgery, rather than a generic schedule.
A modern surgical coordination system will enable outreach in many different formats, such as phone, voicemail, text, and email concurrently to ensure messages get disseminated. Today, given the prevalence of robocalls, many patients ignore phone calls from unrecognized numbers. Using a consistent phone number and clearly disclosing the origin of the number reduces the chances phone calls or texts will go ignored. For certain patients that are not comfortable with exchanging text messages or emails, voicemail reminders can be critical.
Also important is having a gauge for the effectiveness of communication. AI scheduling systems can inform users of which emails have been opened and clicked. If a patient hasn’t engaged with some or all the communications, then the surgeon’s staff knows they should prioritize reaching out to the patient.
In addition, use of an AI-enabled chatbot makes it easy for patients to get fast answers to frequent questions, such as confirming surgery time and location or what to bring when preparing for an inpatient stay. After surgery, patients can send photos of their wounds to their care team, fill out pain, scales and submit data, such as use of pain medication, for healthcare professionals’ evaluation.
With so many surgery scheduling software options to choose from, knowing what will best meet an organization’s needs can be challenging. When leadership examines technologies, emphasis should be placed on effectiveness at meeting key needs, ROI (return on investment), and particular strengths and weaknesses among software competitors.
Make Case Building Easier and More EfficientSurgeon adoption is critical for successful deployment of any solution. If leadership doesn’t find an option that the surgical team prefers, the team will fall back on workarounds with the old, familiar paper-based systems. One of the first questions to ask when comparing surgery scheduling options is whether the software offers quick, seamless case building. Can users save their preferences? Is it easy for them to customize complex cases? Do surgeons actually find the tool beneficial? It’s also important to find a tool that makes the organization less reliant on the surgeon-specific and practice-specific knowledge of individual surgery schedulers. Too many ASCs and healthcare practices grind to a halt if a surgery scheduler is unavailable. Instead, the surgeons’ case preferences and workflows should all be stored in a cloud-based, HIPAA-compliant data repository, making them clear, consistent, and easy to retrieve, regardless of whether a particular scheduler is present that day.
Provide a Comprehensive Overview of Resources and Cases in Real TimeKnowing what resources are available can be incredibly challenging for healthcare practices managing multiple ORs, especially across more than one location. Handling this level of complexity is nearly impossible without a cloud-based surgery scheduling platform that allows for live information updates, automated notifications, and intelligent tools that integrate specific scheduling requirements and changes at the institutional, surgeon, and case level. The right software platform will allow the organization to keep diverse care teams updated whenever there’s a case change or a scheduling delay. This level of transparency makes it far easier to optimize use of the operating room and radically reduces unnecessary downtime and delays. All of this, in turn, ultimately will increase profitability while improving the quality of patient care.
Improve Surgical Block UtilizationIs the scheduler able to rapidly fill schedule gaps? Can the scheduler quickly identify patients that have expressed a preference to undergo surgery sooner if the opportunity presents itself? And can the scheduler readily identify future cases that have already been approved and cleared that would be prime candidates to move earlier? Without such transparency, it is very hard to maximize block utilization. The right surgery scheduling software will help the organization create an optimal block schedule and reduce scheduling gaps. For example, a solution with intelligent learning algorithms can collect and share data to help surgeons improve their estimates of how long each surgery will take. A system with automated notifications and a live, integrated dashboard will help the scheduler make use of unexpected open time blocks and make the most of OR time.
Reduce Patient No-ShowsAs discussed earlier, the most common cause of patient no-shows is miscommunication, such as the patient forgetting the appointment, misunderstanding when the appointment was, or not sharing a scheduling conflict with the healthcare facility in time. Surgery scheduling software should mitigate these issues by enabling the practice to send and track automated notifications and identify patients at highest risk of missing their surgery.
A variety of factors should play into the decision to automate surgery scheduling. ROI will depend on costs as well as a mix of hard and soft benefits. Certainly, the buyer will incur the expense of the platform. And there will be calculations around staff time savings and potential increases in patient throughput.
But to truly maximize return, administrators at surgical practices and ambulatory surgery centers should consider differences among competitors and pursue an approach that factors in the following “dos and don’ts.”
DON’T underestimate the risks of fines and reputational damage due to HIPAA exposure.
A common tipping point for knowing when a software purchase must happen immediately is examining how the team is currently handing its scheduling information. Many surgical practices track portions of the scheduling process with tools like Google calendars, which are not HIPAA compliant. This leaves the organization open to fines and reputational damage from data exposure. The right HIPAA-compliant scheduling software will protect patient information and communications throughout the delivery of care.
DO seek business analytics.
Better understanding where surgical volumes are gaining and losing money is vital to growing the business and supporting profitability. Although managing the scheduling process is core to any software purchase, undervaluing the importance of gaining insights from data can be a critical mistake.
DON’T choose options that require the user to limit access to the system to save money.
For the organization to realize the full benefits of transparent communication, each member of the scheduling, equipment preparation, and surgical teams must be able to view progress as well as the sources of delay. This is the most effective way to save time that otherwise gets lost to duplicative, inaccurate, or poorly timed communications. Individual licenses also can become expensive and difficult to track over time. (Some software vendors have been known to charge not only to onboard new license users, but also to deactivate existing ones!)
DO examine impacts on staff time associated with patient communication options.
Keep in mind that communication capabilities vary. Automated emails and texts are important. But just as powerful are software capabilities that can communicate preparation and after-care instructions not only by procedure but also customized by patient need and physician preference.
DON’T give short shrift to the ease of workflow.
At first glance, workflow optimization may not seem like the most important capability. But surgery scheduling software that employs machine learning and AI can make processes more efficient and easier to execute over time.
DO ask about “extras.”
Costs of surgery schedule software can vary wildly, especially when users may be charged for capabilities such as form customizations or integrating insurance or demographic information or offered confusing discounts associated with terms that are challenging to maintain. When comparing pricing packages, be sure to calculate the complete cost that will be incurred with day-to-day use of the platform.
Ensuring efficient surgery scheduling is vital to managing quality and cost of care. The right surgery scheduling software can empower care teams to better serve patients, mitigate key areas of risk and improve practice profitability.
CaseCTRL is a comprehensive, integrated software solution that helps practices and ASCs manage surgery scheduling more effectively. Using AI-empowered tools such as CaseCTRL’s Case Builder, Intelligent Repository, Surgical Calendar, and Risk Analyzer with automatic notifications, care teams can improve the accuracy and efficiency of their processes. Discover the CaseCTRL difference and request a demo today.