Scheduling

  1. How does everyone handle scheduling? I know that we are nurses and don't usually do scheduling but we are the ones who have to tell the doctor that the receptionist made an appointment and it didn't get in the computer so you have an extra patient today. We also have problem with patients being scheduled with the wrong doctor, if they have seen one doctor then they are suppose to stay with that doctor.

    This last week we had three patients in one day that were scheduled with the wrong doctor. Also another day where three appointment times were messed up, the next day there was two appointments messed up. Help, my doctors are upset and I can't seem to find the best solution.

    Tell me if this happens in your office and what you do. Do you schedule the appointment with the patient or the doctor's office. Do you send reminder cards? We do verify appointments the day before. I am not sure what is happening but would love to hear your input. I would love to hear from receptionist too.

    Jill
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  2. 19 Comments

  3. by   HISSYTHECAT
    I currently work in outpatient scheduling at our hospital. We schedule anything from Ct, MRI, US, Carotid ultrasounds, stress tests, heart caths, pacers, and all sorts of stuff.

    The doctor offices usually call us to schedule the procedures. We have alot of floor nurses that call for pts that are being discharged from the hospital. We do have alot of patients that calls for tests and most of the time we have to call the dr offices to find out what test they are needing and who ordered it. We send out a letter to the patient regarding prep instructions.

    As a former receptionist, I know it is easy to schedule with the wrong doctor and I have learned my lesson about that. I learned to pull the chart on the pt and verify first!!!! Maybe the person scheduling was having a busy moment or something and wasn't concentrating. If it happened at the dr office and I was the physician, I would talk to my staff and let them know my concerns.

    We also pulled charts on patients for appointments at least 2-3 days in advance to look for tests that are needed, labs, and make sure the pt was schedule with the right doc. If they weren't, they we would have enough days to call the pt and reschedule with the correct doctor. They day before the appt, we would run another roster and check for cancellations and note that in the chart and pull any charts for patients that were added on since we last pulled the charts. This helped alot..

    I know I may not be much help but this is just my opinion and what I have learned.
  4. by   2banurse
    Originally posted by Vailgang

    This last week we had three patients in one day that were scheduled with the wrong doctor. Also another day where three appointment times were messed up, the next day there was two appointments messed up. Help, my doctors are upset and I can't seem to find the best solution.

    Tell me if this happens in your office and what you do. Do you schedule the appointment with the patient or the doctor's office. Do you send reminder cards? We do verify appointments the day before. I am not sure what is happening but would love to hear your input. I would love to hear from receptionist too.

    Jill
    It is bound to happen every once in a while but it seems that it is happening a little to frequently in your office. If you feel that you can talk to the scheduler, I would do that first. However, if you feel that you are butting in, then I would go to the office manager and let them be aware.

    Having worked for a wide range of MDs, I know that an office day for them is usually nonstop and of course for the nurse it is no picnic either because they are the first one the MD will let know they are unhappy.

    My pet peeve is when the MD doubles or triple books patients. Then being the scheduler is a nightmare when patients continuously come up and ask when they are going to be seen!

    Kris
  5. by   Vailgang
    Thanks for your input. I work with outpatient scheduling almost on a daily basis so I know what you do. I do like the idea of pulling the charts the week ahead of time. We try to do this on Fridays but this is not always done and they don't check current charts, I will have them start.

    I am the office manager/nurse and the doctors have told me that they don't like the mistakes in the schedule. I have tried to talk to the office staff. Well, Wednesday after the doctor yelled at me, I did the same to her and she quit for about 5 minutes. After a few days of tension in the office I think that today I finally made head way. Our office is VERY busy so every slot is full and adding another patient makes the doctors unhappy.

    I am scheduling a office meeting with the front office next Friday to go over scheduling once again. I was just hoping that you would have a system that would spark my interest and that I could impliment it.

    Keep in mind that the doctor and I have got numerous complaints lately, about the office staff which is only two people. I will address those later.

    Jill
  6. by   HISSYTHECAT
    At our office, we had a check-in girl and a check-out girl. We had one girl that only answered the telephone (that was me) We all three came in at 800am and the phones were turned on at 830 am. Me and the check-out girl would run the rosters and each take a day and pull the charts. We would mark the ones we could not fine. At the end of the day, we would go "chart hunting" This would be the check-in girl cause the pts were there and all the charts were ready for the nurses. Her duties were done for the day

    Then when it was time to turn the phones on, I would go through the charts for the next day, stamped the date, look for all tests and make sure everything was back, check for the right doctor, and put last office note first. Remember, this is in between taking calls. The only thing I would do if a pt needed to make an appt, I would transfer to one of the girls who did not have a pt in front of them. I kept a phone log too and that was very helpful. We had six lines and if line #3 rang in, I knew who it was and what they were holding for. Plus, it came in handy when a pt called in and complained about something. I had everything wrote down. I kept the logs for about 2 months and then shredded them. What helped us alot, was headsets. We had our hands free. I do not know if you have those or not.

    At the end of the day, we would check for any cancellations or add ons for the next day.Pull that chart if needed. This worked out really well. That was my job...phone and charts.

    We had two doctors in our practice. The first doctor would average around 20-25 patients per day. The other doctor averaged about (not kidding) 40-85 per day including post-ops. He would have 3 patients per 15 minutes. I am surprised, but we had all the pts out by 530 pm.

    I hope this helps. It worked great in our office. If you need any other advice, feel free to give me a yell. Hissy :O)
  7. by   HISSYTHECAT
    Vailgang...just thinking about you and thought I would see how things are going with you. How is the scheduling?
  8. by   Vailgang
    Thanks for asking........So far no major mistakes in the schedule lately. It is difficult to schedule in our office do to the demand of patients and limited appointment slots. I am hoping that they have learned their lesson and will pay attention more to scheduling. I try to educate them to the preferences of the doctors but it is difficult.

    This is just one of the many problems I am having in my office at the current time. I honestly don't enjoy being the office manager. The doctor's mother is coming soon and going to be the front office manager and I am so glad!!! I don't like being the office manager and dealing with problem employees.

    Thanks again for caring.:kiss
  9. by   HISSYTHECAT
    I hope things works out well for you and the office. Good luck. Hissy :O)
  10. by   darla80
    Hi Vailgang

    you are right scheduling can be a nightmare.

    I have a couple of questions
    ***Do you use computer scheduling.. if so what is your program?

    ***Are all of the office staff adept at managing the schedule and using the program?
    Sometimes scheduling errors are caused by people who do not use the programs correctly..forget to enter patients etc

    We use Lytec..it is user freindly and can easily be queried..Eg: check appt Mrs jones..all appt dates can be determined with a click

    ***Is your schedule set up with some daily work in slots available? ? We have five slots daily...we can work in the acutes..this really helps.

    I work Internal med and a diabetic with outrageous BS or a new onset Afib or a simple bronchitis...we can get them in. This has helped the scheduler and myself if I have to triage the sick patients


    **Does someone go over the schdule the day before to make certain the charts are ready, the test reports are in and the patient doesin fact need to be seen?


    **Does anyone call the patients the day before to remind them of appt?

    Just a few things that have helped in our office

    Hang in there Vailgang.. keep your head above it alll!!

    I have a pix in my office ..elephant on the beach standing on a brightly colored beach ball the caption.."The key to life is balance"

    ahhh the lessons we learn about life

    email me anytime.. Joy and Smiles * Darla**
  11. by   Vailgang
    Darla,

    We use a computer....the program is through the hospital, called cycare.

    I only have two other people in the office, so when one messes up it is difficult.

    It isn't the best program but can't change because it is through the hospital. You just find the patient, click which type of appointment, select the time and click book. Clicking book seems to be the problem. Also she sends them letters and changes their appointment for some reason and messes up.

    You can always hold appointments for emergency booking.

    The other girl in the front office calls patients that are new and confirms appointments. We only confirm appointments with follow-ups that are bringing films(x-rays, mri's and things).

    It is difficult. She messed up twice Thursday and the doctor was not happy because with our already full schedule we had to add two patients that had appointments that she never "clicked" book.

    She tends to lie and try to cover up. The other girl came to me today and said she noticed that she was finding that she wasn't scheduling referral appointments.

    So I am having other problems with this employee. She also came in late this week. She got there 45 minutes late on Thursday. Said that her alarm was set to pm instead of am

    Also I told her that she needed to make sure that the patient has authorization to see us, we are specialist. Also we deal with tricare that has dated authorizations. She just said well, I try but just can't always do it.

    I welcome all suggestions. Yes, I am documenting everything!!!! I also did an audit of her billilng just to make sure that she is doing it right.

    Sorry so long....Thanks for listening and again I welcome all suggestions. I tried to be demoted from the office manager and they won't do it, so don't suggest that...

    Jill
  12. by   2banurse
    Jill, I think you need to have a serious talk with this girl. The fact that you have a small office should actually work in your benefit. Too many people that would schedule would be more of a problem...JMHO.
    Maybe to start, have a staff meeting amongst the three of you and each member have their say of how to best take care of these problems.

    At that point if you see that she is not giving much imput or possibly acting defensive, I would suggest that you speak with her 1:1. The fact that she said that she tried but just can't always do it tells me that she may need more training or that when she comes up with a problem like this that she let you know asap so that you have time to follow up.
    How long has she worked there? Is she a new employee?

    Kris
  13. by   darla80
    How did the meeting go on Friday?

    I look forward to hearing from you :-)

    It sounds like ther are some difficult things that come along with wearing the title of office manager? ..but what are the things about being office manager that jazz you?

    I hold a degree in psychology as well as my nursing license and I sometimes think about office management positions ..but ..something is holding me back....

    Were you the nurse in that office before becoming manager?

    At any rate ..I do hope the friday meeting went well and you were able to utilize those great critical thinking skills I am sure you are Blessed with and that you were able to solve some of the dilemnas..let us know!!

    Joy and Smiles ** Darla**
  14. by   Vailgang
    Kris,

    I guess I need to air all of my office's dirty laundry, and here it goes:

    This particular girl started in September so yes she is new to our office, she did work in a chiropractor's office for two years prior. I gave her as much training as I could possibly give. She is good just very slow and doesn't seem to care if she messes up and when she does she will never admit it. I have caught her in several lies. She didn't realize that I could track many things that she does and when she found out it shocked her.

    She has called in several times and is often late. I spoke with her and told her that when she is gone, 1/3 of our staff is gone and it makes it very difficult for the office. She said "I will be here unless I am 6 feet under." I thought it was very rude and sarcastic of her to say that." She still comes in late.

    Then she wasn't completing her work. Friday afternoons in our office are not mandatory, but you have to complete your work before you leave. Well, she was leaving anyway. So I made Friday afternoons mandatory to give her time to complete her work. I usually stay until about 2 or 3 but since I am the office manager, I told them I didn't have to stay but could be reached by pager.

    Then she started making mistakes in the schedule and the doctors started getting mad. I could over look a few but it was too many. So one day(Monday), when she had messed up on the third person I made her tell the doctor that she had messed up again. She did and he didn't say anything. He said, that isn't my job it is yours. So I yelled at her. Not in a loud voice but very stern and said that she couldn't make mistakes in the schedule and that it just couldn't happen all the time. She said she quit.

    This is where the saga begins.....She only quit for about 5 minutes. She then called personal and the people who are in charge of the clinic. They told her not to quit and to come the next day. She was sick that week and came in noon on one day. Then on Thursday she messed up on the schedule, this was on the other doctors schedule. I told her that it was important that she not continue to make mistakes in the schedule. She then went to the people who are in charge of the clinic......She made me so mad.

    Anyway, she tried to get me in trouble. They would not return my phone calls so I went to their office on Friday....to be chewed out. I was upset. I talked to the doctors and they supported me all the way and told me to document everything that she wasn't not doing right.

    Then I just thought I was going to tell her just how I felt and why I did the things that I did. She seemed to understand, wishful thinking. She continues to make mistakes, doesn't care and leaves without completing her work. The other girl came to me and told me that she was finding mistakes and didn't know what to do. The other girl was rather upset that she had went to the clinic director too.

    Anyway I am continuing to document everything. I also had them do an audit of the billing because if she is making mistakes in the schedule the doctors wonder what mistakes she is making in the billing.

    So as you can see there are just tons of things going on in the office. I have only touched the surface. I am finding out that I don't like being an office manager but the doctors seem to think that I am doing a good job. The trust me and know that I work hard.

    If you have any suggestions I would gladly hear them. I hope that I explained it good enough to give you some idea what is going on in my office. It is a mess. My biggest thing is that I don't like to be yelled at for mistakes that I didn't make and when you have someone like this girl who doesn't really care, it is FRUSTRATING.

    I have had several conversations with her. I try to tell her that she is doing a good job so she doesn't think that I am always negative. I tell her thank you. I go over and over the schedule and what are good things to do and what are not but it doesn't seem to matter.

    Thanks for listening and if you can help me solve this saga I would appreciate it very much. Oh, one thing that is going to help is that the doctors mother is going to start working in the office and we are going to be dual office managers.

    I look forward to everyone's input.

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