2016 Review of Clinic Consultation by Booked Appointment

2016 Review of ROJoson Medical Clinic Consultation with Appointment Time After One Year of Implementation

In February 2, 2015, I wrote the following:

ROJoson Medical Clinic Consultation with Appointment Time

February 2, 2015

On my 66th birthday, I have decided to try another scheme to decrease the waiting time of my patients consulting me in my clinic in Manila Doctors Hospital (MDH).  [Note: I have tried other schemes before, such as calling before coming; giving out my cellphone numbers; creation of appointment schedule aside from regular schedule; etc.]  I will try “consultation with appointment time.”

Starting February 3, 2015, I advise all patients who want to consult me in my MDH Clinic to call 522-47-13 or 524-30-11 Loc 4100 and talk to Ms. Ma. Lilibeth Tumambing (my secretary) to book for a specific date and time of appointment.  Ms. Tumambing will use a set of guidelines that I will provide in the booking of specific date and time of appointment.

A confirmation-call or communication one (1) day [not later than 12 noon] before the booked date and time of appointment must be done.  Otherwise, the booked appointment date and time shall be cancelled and the resulting available slot will be given to other patients.

Patients with a booked appointment should be at the ROJoson Medical Clinic in MDH DSMT Room 301 at least 30 minutes before the booked appointment time and should inform Ms. Tumambing of their presence.   Otherwise, the booked appointment time slot will be given to other patients.  Late arrival will result in a rebooking of the consultation either to another date or on the same appointment date but at the end of a queue and if there is still a slot available (Note: there is a preset limit in the number of patients to be seen for each clinic day.)   Advice: Be on time and 30 minutes before a confirmed booked appointment time.

Ms. Tumambing and I will publicize and dry-run this scheme for the whole month of February 2015.

We will refine it as needed until we reach this target: a cycle time of not more than one-and-a-half (1.5) hour in 90% of patients who go to ROJoson Medical Clinic for medical consultation.  The cycle time starts from the patient’s required arrival (30-minutes prior to booked appointment time) to completion of actual consultation.

This will be another legacy that I will accomplish for my patients.

Note: In the near future, we will provide our patients with schemes on how to facilitate communication for booking appointments as well as how to get a parking space in the perimeter of MDH.

 

In April 3, 2015, I made a formative review.

Review of ROJoson Medical Clinic Scheme of Consultation Based on Appointment Time

Reynaldo O. Joson, MD

April 3, 2015

Goals:

To avoid long-waiting time of patients consulting at ROJoson Medical Clinic.

To have a waiting time of patients consulting at the ROJoson Medical Clinic not more than 1.5 hours.

Key Performance Indicators:

1.       Dr. R.O. Joson starting clinic session on time (on declared starting time) – starting April 7, 2015

2.       The waiting time of patients consulting at ROJoson Medical Clinic is not more than 1.5 hours.

a.       Inclusion: patients with booked appointment time and who arrived 30 minutes before booked appointment time.

b.      Exclusion: patients with booked appointment time and who did not arrived 30 minutes before booked appointment time.

c.       Exclusion: patients with no booked appointment time (old patients and new patients)

Strategies:

1.       Dr. R.O. Joson shall start on time (on declared starting time).

2.       Patients shall be given an appointment time and they have to confirm their appointment time a day before.

3.       Patients shall have to arrive 30 minutes before the appointment time.

4.       Dr. R.O. Joson shall have a contingency plan to adjust to any prolonged consultation time so as to ensure no patients shall have a waiting time of more than 1.5 hours.

Mechanics:

·         There will be a maximum of 20 patients per clinic session.

·         There will be a maximum of 16 patients with booked appointment time.  Four slots will be allotted for walk-in patients (new or old patients) without booked appointment time.  If there will be less than 16 patients with book appointment time, more slots will be allotted for walk-in patients as long as the maximum of 20 patients per clinic session is maintained.

·         A patient is booked for an appointment time, NOT a number.

·         A patient without a procedure to be done will be allotted 10 – 15 minutes for clinic consultation.

·         A patient with a procedure to be done will be allotted 15 to 30 minutes for clinic consultation.

·         A patient has to call up the ROJoson Medical Clinic secretary (522-47-13 or 524-30-11 Loc 4100) for an appointment date and time.  Booking may be done 3 months before; 2 months before; 1 month before; 1 – 2 weeks before; or even 1 day before.

·         There shall be a confirmation of the booking one day before the appointment date. Otherwise, the booking shall be cancelled.

·         A patient with a booked appointment time must arrive at the clinic 30 minutes before the appointment time.  He/she must inform the clinic secretary of his/her arrival time.

·         If late, a patient with a booked appointment time can be accommodated on certain conditions: he/she will be queued at the end of list of patients already booked for consultation on that day and as along the maximum of 20 patients per clinic session has not been reached.

·         There will be a lunch break of 15 minutes for Dr. R.O. Joson and his clinic secretary.

·         Typical clinic sessions of ROJoson Medical Clinic:

10 am 11 12      

10-12

8 pts

10 am 11 12 1    

10-1

12 pts

10 am 11 12 1 2  

10-2

16 pts

10 am 11 12 1 2 3 pm

10-3

20 pts

 

9 am 10 11      

9-11

8 pts

9 am 10 11 12    

9-12

12 pts

9 am 10 11 12 1  

9-1

16 pts

9 am 10 11 12 1 2 pm

9-2

20 pts

 

·         Records to track achievement of key performance indicators:

ROJoson Medical Clinic

Tracking of Waiting Time of Patients (April 2015)

Date: Time Booked Time Consultation Started Time Consultation Ended
ROJoson      
       
Name of Patients

(with booking)

     
1.      
2.      
3.      
4.      
5.      
6.      
7.      
8.      
9.      
10.      
11.      
12.      
13.      
14.      
15.      
16.      
17.      
18.      
19.      
20.      
Name of Patients

(with no prior booking)

     
1.      
2.      
3.      
4.      
5.      
6.      
7.      
8.      
9.      
10.      
Name of Patients

(with booking but late on arrival)

     
1.      
2.      
3.      
4.      
5.      

 

January 29, 2016 Review

In April 2015, I made a 2-week monitoring run of the scheme and then stopped it as I saw the patients were satisfied with the scheme.  They preferred this scheme over the first come first serve as the waiting time was not too long (acceptable to the majority).

The main problem has been that majority of the patients do not arrive on time (should be 30 minutes before the scheduled appointment).  This tends to disrupt the smooth implementation of the scheme.  The secretary had to adjust the schedule more often than not and I, as the physician, tended not to follow the time allotted for each patient.  I tended to extend the consultation time because the next patient was not yet around.

I, as the physician, can honestly say that I was late only once during the entire year of clinic sessions.  I was late only for 30 minutes.  I was caught in a surgical operation that I scheduled before my clinic session.

What are the areas of improvement and how to go about it?

First of all, on my 67th birthday, I still want to decrease the waiting time of my patients consulting me in my clinic in Manila Doctors Hospital (MDH) as this is one of the legacies that I will accomplish for my patients.   This year, I will make changes for improvement.

Here are my action plans:

1.       I will do the scheduling myself for one to two months as my secretary still has a hard time determining how much time to allot for each patient.  I will give my cellphone number to the patients.  They will text me.  I will be the one to give their scheduled time of appointment.  Once I have the system going smoothly, I will train and endorse it to my secretary.

2.       I have to discipline the patients on coming on time.  They have to come on time, 30 minutes before the scheduled appointment time.  If they don’t come on time, they will be moved to the last slot and / or be fined.

3.       I have to discipline the patients also on confirming a day before and cancelling on time if they cannot make it on the scheduled appointment time.

4.       I will do regular monitoring of the implementation (2 weeks every other month for 2016) using a checklist.

5.       I will continue to start on time (based on declared starting time).

6.       I will continue to follow the basic plans that I put up in April 3, 2015.

Goals:

To avoid long-waiting time of patients consulting at ROJoson Medical Clinic.

To have a waiting time of patients consulting at the ROJoson Medical Clinic not more than 1.5 hours.

Key Performance Indicators:

·         Dr. R.O. Joson starting clinic session on time (on declared starting time).

·         The waiting time of patients consulting at ROJoson Medical Clinic is not more than 1.5 hours.

·         Inclusion: patients with booked appointment time and who arrived 30 minutes before booked appointment time.

·         Exclusion: patients with booked appointment time and who did not arrived 30 minutes before booked appointment time.

·         Exclusion: patients with no booked appointment time (old patients and new patients)

Strategies:

·         Dr. R.O. Joson shall start on time (on declared starting time).

·         Patients shall be given an appointment time and they have to confirm their appointment time a day before.

·         Patients shall have to arrive 30 minutes before the appointment time.

·         Dr. R.O. Joson shall have a contingency plan to adjust to any prolonged consultation time so as to ensure no patients shall have a waiting time of more than 1.5 hours.

Mechanics:

·         There will be a maximum of 20 patients per clinic session.

·         There will be a maximum of 16 patients with booked appointment time.  Four slots will be allotted for walk-in patients (new or old patients) without booked appointment time.  If there will be less than 16 patients with booked appointment time, more slots will be allotted for walk-in patients as long as the maximum of 20 patients per clinic session is maintained.

·         A patient is booked for an appointment time, NOT a number.

·         A patient without a procedure to be done will be allotted 10 – 15 minutes for clinic consultation.

·         A patient with a procedure to be done will be allotted 15 to 30 minutes for clinic consultation.

·         A patient has to text ROJoson (09188040304) for an appointment date and time.  Booking may be done 2 weeks before or even 1 day before.

·         There shall be a confirmation of the booking one day before the appointment date before 12 noon. Otherwise, the booking shall be cancelled.

·         A patient with a booked appointment time must arrive at the clinic 30 minutes before the appointment time.  He/she must inform the clinic secretary of his/her arrival time and show the SMS appointment time received from Dr. ROJoson.

·         If late, a patient with a booked appointment time can be accommodated on certain conditions: he/she will be queued at the end of list of patients already booked for consultation on that day and as along the maximum of 20 patients per clinic session has not been reached.

·         There will be a lunch break of 15 minutes for Dr. R.O. Joson and his clinic secretary.

·         Typical clinic sessions of ROJoson Medical Clinic:

10 am 11 12      

10-12

8 pts

10 am 11 12 1    

10-1

12 pts

10 am 11 12 1 2  

10-2

16 pts

10 am 11 12 1 2 3 pm

10-3

20 pts

 

9 am 10 11      

9-11

8 pts

9 am 10 11 12    

9-12

12 pts

9 am 10 11 12 1  

9-1

16 pts

9 am 10 11 12 1 2 pm

9-2

20 pts

 

·         Records to track achievement of key performance indicators:

ROJoson Medical Clinic

Tracking of Waiting Time of Patients (February 2016)

Date: Time Booked

(a)

Time Arrived

(b)

Time Consultation Started (c) Time Consultation Ended (d) Total Time

Consumed

(d-b)

ROJoson          
Name of Patients (with booking)          
1.          
2.          
3.          
4.          
5.          
6.          
7.          
8.          
9.          
10.          
11.          
12.          
13.          
14.          
15.          
16.          
17.          
18.          
19.          
20.          
Name of Patients

(with no prior booking)

         
1.          
2.          
3.          
4.          
5.          
6.          
7.          
8.          
9.          
10.          
Name of Patients

(with booking but late on arrival)

         
1.          
2.          
3.          
4.          
5.          
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