May 13, 2024
Apr 15, 2025
Written By Elizabeth Cifers
It’s the end of the day. One of your physicians is working late with a patient while her scribe and a member of the front desk stay to support her. It’s been a hectic day for everyone—physicians, staff, and patients. As the rest of the team makes their way out of the door, you overhear grumbling about how stressful the day was. Another schedule that didn’t work well will be thrown out the window. It’s beginning to feel like the norm.
While “perfect” days aren’t always possible in a retina clinic—given that some retina conditions are urgent, there are too many variables for a consistently flawless schedule—a pattern of “bad” ones is fixable. Read on to learn how to improve patient flow at your retina clinic.
Patient flow is the part of the revenue cycle concerned with the patient movement from point A to point B, from the initial call to schedule the appointment to check-out. It can be broken down into 6 steps:
Improving patient flow involves identifying inefficiencies at each of these steps and implementing fixes. See the patient flow chart below for an illustration of these steps:
Inefficient patient flow ultimately costs your retina clinic revenue by creating schedule delays, frustrating patients, and stressing staff. If possible, anything delaying your physician(s) from the clinic and prohibiting them from seeing a full schedule of patients while maintaining the highest standards of care should be observed and corrected.
Each retina clinic has its challenges and could benefit from a personalized clinical operations assessment or revenue cycle review. Still, the following general tips can apply to any physician's practice:
Ideally, patients should move continuously forward, with no backtracking. However, most retina clinics have an existing layout that you must make work. Reviewing the movements can improve the flow of patients, staff, and physicians.
Look at the flow from workup, dilation, testing, exam, and check-out. How much movement occurs? Are there ways to cut down on back-and-forth? Most retina practices work in a circle, starting at check-in and moving in the same direction to come out at check-out, or they are linear, meaning start at check-in, work in the same direction, then follow the hallway back where you started.
If each workup tech has an assigned room, the flow will be smoother because they won’t spend time and energy looking for an open lane. Additionally, utilizing the physician exam rooms for the first patients of the day may streamline the process. In many retina clinics, the physician uses two or three rooms nearby, moving between each to examine and treat patients.
When selecting one workup and exam room to have a wheelchair glide, consider the flow and how many patients you typically encounter who cannot transfer to the exam chairs. If you have a small or awkward exam room, it may be beneficial to establish it as a procedure-only or laser room. Again, remember the movements to get the patient and physician to and from the area.
Are slow computers making check-in a nightmare? Is your practice management software lagging as staff struggles to schedule patients, pull up charts, and type notes? Or is your internet slow? Maybe your equipment keeps malfunctioning, or your software tools are unintuitive. The right tools will make a difference in your patient flow. Keep an ear open for complaints about uncooperative equipment and be ready to address issues promptly. Investing in reliable technology may seem like a waste of money, but inefficiency is equally wasteful.
Several processes are crucial to patient flow at your retina clinic. This list includes but is not limited to:
Missing any of these processes could be the hangup in your patient flow. For more information on processes, see Iterative Processes in Practice Management.
One issue that can significantly hinder smooth workflow and deserves its spotlight is poorly stocked exam rooms, which result in extra trips by technicians, scribes, or physicians. Establish an inventory for each room and assign a staff member to maintain it—an excellent task to rotate through your technicians who open or close the exam lanes daily. Your team and your revenue will thank you.
This is a big one. Physician(s) are the limited resource. Patient flow improvement centers on keeping your physician(s) in the clinic as much as possible. Your physician(s) should move from ready patient to ready patient with limited additional steps and minimal interruptions. If the clinic schedule isn’t working, collaborate with the physician on the schedule to find something that works. Additionally, physicians should not escort patients to check out. Each additional step is a microsecond tallied against your profit.
![Improving Patient Flow at Your Retina Clinic [Chart Included]](https://cdn.prod.website-files.com/67dae3085c06499274368620/67fefb7fb3a8668bf6f773f2_Patient%2BFlow.png)
Efficiency comes naturally to the rare few, and not everyone has learned the best work practices in their careers. Even fewer keep efficiency top-of-mind. Your staff may need training or a refresher in efficiency basics to benefit patient and clinic flow. Note also that productivity issues may stem from a lack of proper practice procedure training rather than efficiency training needs.
Do you know the “high” that comes after training? The one where everyone is informed and excited to implement what they’ve learned? Find ways to keep the high from fading. Keep the conversation going, whether throughout the day or at staff meetings. Don’t be afraid to entertain changes. Creating an efficient culture to benefit patient flow may mean scheduling regular refreshers, too.
A lofty goal like “improve patient flow” will remain vague and unaccomplished unless it’s broken down into specific objectives and assigned to responsible parties. Create a team of a few staff members (including at least one physician) to meet regularly to discuss improving patient flow. Survey team members, create recommendations, and implement agreed-upon changes. Improving patient flow should be an ongoing initiative.
Poor patient flow at your retina clinic may result from personnel scheduling. Consider creating staggered start times for reception, workup techs, and scribes by creating ‘early’ and ‘late’ times for each that are rotated between staff. Essentially, the staggered times will allow for less overtime during the week; everyone has a day they can be off work early, and everyone takes turns coming in late and being the last ones done. Don’t be afraid to explore other staffing models and experiment with different task assignments within your team.
Key performance indicators (KPIs) tell you whether you perform to a certain standard in a given area. They can be based on industry standards or the historical performance of your retina clinic. For patient flow and efficiency, we can look at Net Collections per Full-Time Employee (FTE) MD, Net Collection per FTE Staff, and Staff per FTE MD, to name a few. Investigate red flags in any of these metrics and fix issues where you find them.
Improving patient flow is vital to unlocking revenue efficiency at your retina clinic. It requires a systematic review of processes to determine if there are inefficiencies and take the action needed to correct them. Some inefficiencies can be identified using KPIs. Common sticking points include practice layout, technology, and administrative processes. Staff can be trained to prioritize efficiency in day-to-day operations and become advocates for patient flow at your clinic.
Hiring an expert to perform a comprehensive clinical operations assessment of your retina practice can be valuable. An expert would be familiar with common patient flow challenges and experienced in developing creative solutions. Clinical consultant Elizabeth Cifers possesses decades of experience in medical administration, including 13 years as a retina practice administrator and a senior consultant position at a leading eye care firm. She is well-versed in efficiency and patient flow and would be happy to discuss the needs of your retina clinic. Schedule a free consultation with Elizabeth here.
.png)
