Queuing systems: the vitals

In the last post, I mentioned that I would go deeper into queuing systems in the next writing.  As mentioned earlier, a queuing system basically tracks each patient as they move from point to point during a visit to the office.  In addition to noting which patients are where in the office, you can also see how long the patient has been in that area.

At My Practice Engine, the primary experience we have had with queuing systems is building one from the ground up.  Our patient flow protocols were already in place and our IT team built queuing into our practice management system around those protocols.  

In sum, a queuing system, when used properly, can provide extremely valuable information.  The key phrase there is “when used properly” because if used improperly, it is a waste of hardware and software.  We had one manager simply go in at various times of the day and mark every patient in the office as checked out.  So, at a specific time of day, 15 people all left at once.  I hope they had someone to hold the door for the rush of folks.  

When used properly however, there are a number of ways to use one.  One extremely simple way is to note the time a patient arrived at the office and the time that person left.  Now, that isn’t the hardcore “queuing” or tracking that the term traditionally implies, but can give you useful information.  Here’s how: 

Let’s say you are tracking check ins and outs.  After a month, you run a report and find that all of your short appointment patients are in the office for 40 minutes total while all the long appointment patients are in the office for 75 minutes total.  A long appointment should only last about 20 minutes more than a short so why the large spread?  There may be a treatment difference or a procedural difference, but that data lets you know that there’s something to be examined more closely.

When it comes to the nitty gritty tracking of patients at each stage in the process (waiting room, on deck, clinician’s chair, on deck again, doctor’s chair, checkout), we have traditionally seen 2 main objections:

1. Cost – Most offices will want to have a terminal next to each chair and in key areas like on-deck spaces.  This requires spending on hardware and possibly additional software licenses for something that can be of questionable value.  Mobile devices, cheap hardware and online practice management software have largely allayed those concerns.  On top of that, you probably benefit most from this only when you have enough patients to merit a queuing system.  So, hopefully you are not a money losing practice just adding more expense.
2. People actual have to do the data entry – This is particularly challenging on busy days when patients are rolling through.  It’s easy to forget that you needed to note that Bobby was done in your chair and waiting to see the doctor.  To remedy this, you need to assign a person early in the implementation to be the queue police (or Q-Police if you prefer).  This person will keep an eye on things and remind staff when they fail to check the right box and review reports at the end of the day to see where errors lie.  After time, the process becomes part of the every day routine.  Also, start simple and then get more complicated.  If you are just starting to go to the gym, you don’t usually jump right into a 2-hour nonstop workout multiple days each week.  You start slow and build up.  Just get the check in and check out right and then move on to the time in the clinician’s chair (very telling).

On other note on check-in and queuing.  We’ve worked with setting up a check-in kiosk to free up the front desk to engage in other productive pursuits.  For me, this makes the practice seem more impersonal and industrial.  That quick smile and greeting from a friendly front desk person can make a huge difference.

Finally, you can probably guess that using a system like this can generate a tremendous amount of data.  If you want, you can determine how much time a patient spends in clinician X’s chair for Thursday short appointments.  That’s why you need data analysis tools to pick out the problem areas and display only those.  If a patient should be a in a clinician’s chair for 15 minutes and everyone is coming in at 13-17 minutes, you are good to go.  It’s that one person at 25 minutes that requires some additional attention.  

Like with everything else, more data only works if it doesn’t bog you down and if it points you in the right direction.