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

Nathan Shields • June 8, 2021
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 i s  complete d. 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 , “W hatever happened to that guy ?   W hatever happened to that girl ?   S he  came in a couple of weeks ago   for her knee  and  now she ’ s not here anymore. ”   Worst  of all ,  “W e 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  cancelin g,  not rescheduling,  and  going on vacation  and  then not returning for physical therapy , y ou  name it.  


The statistic that we want to improve with this particular action is increasing our percentage of completed plans of care.
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Ultimately,  that leads to poor outcomes for the patients , l ost 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 . H opefully, 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  a re 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   obvious ly   who  agreed with the physical therapist that they ’ re not coming anymore. They pop ped  the champagne ,  got the coffee mug  and  t-shirt s,  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 . W e ’ 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  t his 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 .   D epending on who you listen to ,  t hat could be 10 %  to 20% of all  p atients 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, i f we ’ re only see ing 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 EMR s  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  responsibilit y 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 .   T he 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 .   M aybe  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 patien t s ’   plans of care   being completed .   H appy 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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