Nathan's Coaching Moment: The One Meeting That Has To Be Done Weekly

Treating patients isn’t just about getting them through the door. You and your team also need to make sure their plan of care is completed. Our host, Nathan Shields, flies solo today as he talks all about making sure no patient falls through the cracks. Nathan discusses how to plan and execute a weekly walkthrough to make sure all active patients are attended to. We also hear about the benefits this brings, not just to the patients, but to your health care providers as well.

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Nathan’s Coaching Moment: The One Meeting That Has To Be Done Weekly

I want to share with you something that I’ve been working on quite a bit with my coaching clients. Something that we use to address issues regarding retention, situations in which maybe there’s a busy season or you’re expecting a busy season, but you’re not as busy as you think you should be or just those situations when you might be thinking, “Whatever happened to that guy? Whatever happened to that girl? She came in a couple of weeks ago for her knee and now she’s not here anymore.” Worst of all, “We had a ton of new patients and our total visits aren’t going up significantly this week. It seems like people have dropped off.”

That issue came up routinely for us in our clinics. There was one thing in particular that we did that helped it out and that was called the weekly walkthrough. You might be doing your version. You might even call it something different and that’s great. I’d love for you to share with the other owners what you’re doing. Share with me and I’ll let other people know, especially if it’s a good idea. The issue generally comes up that patients are falling through the cracks. You’ve got poor retention efforts or we’re not doing anything retention–wise to keep patients in the books. They’re canceling, not rescheduling, and going on vacation and then not returning for physical therapy, you name it.

The statistic that we want to improve with this particular action is increasing our percentage of completed plans of care. Click To Tweet

Ultimately, that leads to poor outcomes for the patients, lost patients, and revenue. That poor outcome for the patient eventually leads to a poor reputation for you because now they’re not getting the results that they want. Hopefully, but routinely, it gets back to the physician, “That physical therapy clinic didn’t work for me. We need to move on.” That ends up being a loss of referrals for you, not in terms of the physicians, but also, they’re not going to refer to their family and friends. What is one thing at least that we did on a routine basis to help with these issues? That was called the weekly walkthrough. This is where it was simple. We got an Excel spreadsheet, listed all of the active patients and their future appointments with notes available to list any communication efforts that we’ve made. First on, list of active patients, next few columns the appointments that they had scheduled coming forward, and then lastly, any communication efforts that were made.

Each patient on the list was addressed, whether they’re scheduled or not. What is their status? What are the communication efforts? If you can take it to the next level, the frequency in which they are scheduled at an appropriate level for their appropriate plan of care. Lastly, we would talk about who was formally discharged and informally discharged from that list. Formal discharge was obviously who agreed with the physical therapist that they’re not coming anymore. They popped the champagne, got the coffee mug and t-shirts, they high-five, celebrity walkthrough, and lead them out the door. They were formally discharged versus those who simply aren’t returning your calls. Those are the informal discharges. We’ll talk about the important statistic to track that.

Ultimately this walkthrough is focused on patient retention and that patient retention leading to happy and engaged patients meeting their goals. The statistic that we’re going to try to improve with this is the percentage of completed plans of care. That’s the statistic I was talking about with the discharges. That percentage of completed plans of care is notoriously poor for our profession. Depending on who you listen to, that could be 10% to 20% of all patients that come through our doors are actually completing their full plans of care and meeting their goals, which is horrific. It’s lost money, lost revenue, and poor reputations, you name it. It’s all that stuff.

The statistic that we want to improve with this particular action is increasing our percentage of completed plans of care. Another byproduct of it could be increasing the frequency per week that we see those patients. Inherently, if we’re only seeing them one time a week in a typical orthopedic clinic, they’re probably not getting well and not meeting their goals. They’ve got to come 2 to 3 times a week, so you want to address that as well. What can the results be from the weekly walkthrough? The results are increased total visits, which leads to increased revenue, increased bottom line, profits, and the patients ultimately are getting better. They’re following through with their plans of care. The weekly walkthrough is a must and we called it the weekly walkthrough because we literally walk through each chart back in the day of each patient in our file folder in the file cabinet. We’re old school. That was how it was back in the day. Now your EMRs can print out some of those sheets. Some of them aren’t very trustworthy, depending on your EMR. It might be better for the front desk person to literally print all of the active patients and keep that active patient list going. That’s the kicker.

Here’s the secret. This is the front desk’s responsibility. This is not your responsibility. Your responsibility is to make sure that this meeting happens, same day, same time, every week. Ensure that it happens and that all the active patients are addressed. The responsibility to keep that active patient list up–to–date and fully communicated is the front desk’s responsibility. They should be living in that form throughout the week, knowing where all the active patients are and exactly what efforts have been made to get those patients on the schedules.

Ultimately in an ideal situation, I, as the leader, would come into the meeting. The front desk would hand me the Excel spreadsheet with all the patients listed, all their scheduled appointments. If they don’t have any scheduled appointments in the near future, especially the next week, notes are made as to what their communication efforts have been and where that patient is. Maybe they’re on vacation or something that’s happened that they can’t come in. Everything is listed and they report to me exactly what is happening with all of our active patients.

PTO 147 | Care Plan — Care Plan: The responsibility to keep that active patient list up-to-date and fully communicated is the front desk’s responsibility. They should be living in that form throughout the week, knowing where all the active patients are and exactly what efforts have been made to get those patients on the schedules.

Recognize this is the front desk responsibility and it needs to be reported up to you. That is their job to ensure that all the patients are on the schedule and make sure all their patients who are scheduled come in. That’s why one of their main products is arrival rate, but make sure that all the patients who are on the schedule to actually come in for their visits and ultimately, fill the schedules of the providers. That’s their job. Make sure that this one meeting happens and what will you benefit from it? You’ll see an increase in total visits. You’ll see an increase in revenues, increase in patients’ plans of care being completed. Happy patients that are engaged in referring friends and family and doctors who are happy that the patients are getting better and thus, willing to send you more patients. This one thing can help you with all of those byproducts and increase all of those statistics, making you a happier owner. Recognize that the secret to it all is that you’re not in charge of it.

Yes, initially you’ll have to do some training. You’ll have to show them what to do and how to do it, but then eventually, they have to take ownership. This is their responsibility. They are supposed to lead out in this meeting and show you exactly what’s happening with all the active patients that are coming through your doors, so they are not falling through the cracks and not getting better. The weekly walkthrough, I highly recommend it. It has to be done on a routine basis and if you do so, things will improve in your clinic. That’s my moment for the day.

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