Tuesday, April 15, 2008

Block Booking for Chronic Care Patients

Mr. Jones needs to follow-up in a month for hypertension. How many blocks of time should you reserve, a month from now, for patients like Mr. Jones? Calculating blocks of time for chronic care is pretty straight forward.

First, identify a group of patients. The group doesn’t have to have the same disease but they do need to have the same time requirement in the schedule (15min, 20min, etc…), the same return frequency (1 month, 2 months, etc…) and the same resource requirements (does not need blood work, will need to see the nurse first, etc…). Once you’ve identified the group of patients use you’re electronic scheduler to create an appointment type with it’s own unique colour. This makes it easy for the front desk to identify how many patients are already booked in a day. As an example, all stable hypertension and asthma patients that are on 6 month recall schedules could be coloured purple in the scheduler.

First count back how many patients (of the group you’re blocking) were seen in the past. Count back 3x the length of the recall period. For instance if the follow-up is 1 months, count back 3 months. Next count back how many days were available to those patients during that time. If the practitioner was available 3 days per week for those patients x 12 weeks than there were 36 days available.

Finally divide the number of patients in the past 3 months by the number of days and this is the number of blocks to reserve per day.


Hypertension and type II IDDM follow-up 1 month:
In last 3 months: 472 patients of this type booked (includes no shows)
In last 3 months: 20 days available for this type of patient
Block booking: 472/20 days = 7.9 appts per day round up to 8 appts per day

As you go forward the front desk will get a “feel” or better have a technology tools in the scheduler to measure the wait time for this type of patient. As the wait time extends beyond a month slots are added and as it drops below slots are removed. Consistency and working to decrease no-shows will improve efficiencies and allow fewer slots per day. If the provider changes the number of days worked the slots will have to be adjusted as well.

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