Central Scheduling: Its Impact on the Outpatient Service Line Transformation

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Leadership and Management

Airica Steed, RN, BSN, MBA
Administrator, Organizational Effectiveness
Advocate Condell Medical Center

Lorraine Saintus, MSPH
Senior Operations Excellence Consultant
Advocate Condell Medical Center

The outpatient service line is one of the largest revenue-generating profit centers at Advocate Condell Medical Center. Central scheduling is the heartbeat and front door of patient services, which jumpstarts the revenue cycle and the patient experience. An opportunity existed to transform existing practices in order to maximize service excellence and enhance revenue cycle performance.

It was the goal of Organizational Effectiveness to improve outpatient service line capacity by improving overall efficiency and maximize outpatient volume with existing resources without compromising patient safety and satisfaction. It was the goal to increase the number of scheduled appointments versus spontaneous walk-in visits to appropriately manage capacity and demand and to ensure that staffing resources were matched appropriately to volume.

In order to have a true outpatient service line transformation, all key workflows that impacted were analyzed including Outpatient Scheduling, Order entry, registration/intake/access, and all other service line modalities by way of utilizing a mixed methods approach inclusive of LEAN, Six Sigma and CAP.

As a result, a true centralized scheduling process was created which resulted in a 90% reduction in workflow steps and process waste, >50% reduction in call length, and >70% reduction in abandoned and dissuaded calls, reduction in cancelled/missed appointments, increased cash collections prior to the day of service, and 100% of scheduled appointments pre-registered prior to the day of service. Due to the streamlined workflow, the department converted to an "all green" process which produced a significant cost reduction in supply costs. The Central Scheduling department expanded their hours of operation to capture new patients and instituted a reminder system to reduce number of missed/no-show appointments and to recover re-scheduled appointments more efficiently.

As a result of eliminating waste, standardizing processes, and streamlining non-value added activities in the newly Centralized Scheduling department, the Outpatient Service Line was significantly impacted. It is projected to have > 10% increase in new patient volume (annualized ROI projected at >$1.5 million dollars).