Effective Appointment Scheduling Effective appointment scheduling 1 Objectives

Effective Appointment Scheduling Effective appointment scheduling 1

Objectives – to understand: �Why effective scheduling is important �How automated scheduling helps with effective appointment scheduling �Why clients cancel appointments �Client education �Appointment scheduling policies and procedures �How to eliminate no-shows and cancellations Effective appointment scheduling 2

Why is Effective Appointment Scheduling important? Ø The appointment schedule is the central focus of all dental offices. Ø Effective management of the appointment schedule drives the productivity and profitability of the practice. Effective appointment scheduling 3

Why is Effective Appointment Scheduling important? Ø If the appointment schedule is not filled: § the costs of running the practice increase (overhead expenses rise); § cancellations that cannot be filled result in a lost opportunity to increase revenue; § the practice is not reimbursed for the direct costs of cancellations e. g. wages and rent. Effective appointment scheduling 4

Question: Identify one reason why effective scheduling is important. Effective appointment scheduling 5

Automated scheduling Ø The use of automated scheduling enhances the office’s ability to: § schedule appointments; § evaluate client management information; § identify areas for improvement in services; § provides opportunities to identify appropriate allocation of appointment times. Effective appointment scheduling 6

Software programs Most schedulers should be able to provide tracking information on: Ø Numbers - number of cancellations Ø Reasons – reasons for cancellations Ø Ø Success - success of the continuing care program Ø Timeliness - percentage of appointments that begin and end on time Ø Usage - use of the operatories (treatment rooms) Effective appointment scheduling 7

Software programs Most schedulers should be able to provide tracking information on: Ø Length - length of procedures for dental providers Ø Average time- total average time required for each procedure Ø Effectiveness - effectiveness of confirmations Ø Types - types of appointments scheduled Ø Unused time - Downtime, or unused chair time Effective appointment scheduling 8

Question: What do you think are the most common reasons client’s change or cancel appointments? Effective appointment scheduling 9

Most common reasons client’s change or cancel appointments Ø They forgot. Ø They don’t see why the appointment is important. Ø They are concerned about the costs. Ø They are scared. Ø They are unsure of how long the appointment will take. Ø They are new and therefore have no ‘relationship’ with the staff so do not feel guilty about cancelling. Effective appointment scheduling 10

Client Education The clinical team must make sure that, before the client leaves the office, they are aware of: Ø The value of the care they received and why it is important Ø The next steps in the treatment plan Ø The advantages of proceeding with the recommended treatment Ø Risks and consequences of not receiving treatment Ø The expected cost associated with the treatment Ø Time frame in which the appointments need to occur Effective appointment scheduling 11

Client education continued Ø Therefore before clients leave the office, they should have a tangible commitment to return for ongoing care. Ø Schedule the next appointment and educate clients about: § the importance of keeping the appointment; § the value of the care. Ø When clients agree and commit to a specific time to return, they are more likely to honour the commitment. Effective appointment scheduling 12

Question: What should client’s be educated about? How will this help to reduce cancellations? Effective appointment scheduling 13

Appointment scheduling policies and procedures Ø The appointment scheduling policy should begin with a policy statement which is then followed by step procedures. Ø Policy rationale: § The appointment schedule is the central focus of the dental clinic. § Control of the schedule will be maintained through effective scheduling techniques. § This will maximize efficiency yet minimize stress. § All clients will have a tangible commitment to return. Effective appointment scheduling 14

Appointment scheduling procedures – things to consider Ø Confirmations Ø Handling no shows and cancellations Ø Verbal skills for offering appointments Ø Tracking unscheduled treatment for each dental provider Ø Treating Emergency Clients Ø Block Scheduling Ø Time Management Ø Late Clients Effective appointment scheduling 15

Appointment scheduling procedures. Confirmations Ø All scheduled appointments should be confirmed. Ø However, when communicating with the client do not use the word confirm as this implies the appointment was not ‘firm’ to begin with. Ø The dental assistant can say “I am calling about your appointment with Dr. David tomorrow at 10: 00 am, I just wanted you to know we will have everything ready for you. We look forward to seeing you. ” Effective appointment scheduling 16

Appointment scheduling procedures. Confirmations cont’d Ø If a message must be left on an answering machine the dental assistant should identify him or herself and ask the client to call the office. Ø Due to privacy laws the date and time of the appointment should not be included in the message. Ø If a message is left the appointment should not be considered a confirmed appointment. Effective appointment scheduling 17

Appointment scheduling procedures. Handling no shows and cancellations Ø Cancellations are discouraged and should be followed up immediately. Ø If a client cancels the dental assistant should call the client within 5 minutes of the cancellation. Effective appointment scheduling 18

Appointment scheduling procedures. Handling no shows and cancellations cont’d Ø If the reason is because of an unusual circumstance the client should be rescheduled for the next available date and time. Ø If the reason is a one time occurrence the client should be rescheduled for the next available date and time. Effective appointment scheduling 19

Appointment scheduling procedures. Handling no shows and cancellations cont’d Ø If the client can be reached by telephone the dental assistant should: § Express concern e. g. “Mr. Smith , I was worried about you. Is something wrong? We are waiting for you? ” § Try to help the client commit to another appointment § If the client cannot be reached by telephone a letter should be sent immediately. Effective appointment scheduling 20

Appointment scheduling procedures. Handling no shows and cancellations cont’d IMPORTANT: Ø the reappointments of no-show clients and last minute cancellations should occur during hours that represent slow time or downtime. Effective appointment scheduling 21

Appointment scheduling procedures. Cancellations Ø Appointment cancellations=lost revenue. Ø Practice owner still has to pay rent, electricity, wages etc. Ø If there is no revenue then the practice cannot achieve its targets. Ø 1 or 2 cancellations per day may not sound like much but it equals to a lot of lost revenue. (2 cancellations per day = $50, 000 per year lost revenue) Effective appointment scheduling 22

Appointment scheduling procedures. Cancellations cont’d Ø The Dental Office Assistant MUST: § determine why clients are cancelling; § examine how cancellations are being handled. Ø Cancellations may be avoided by TRAINING everyone involved in scheduling clients in the policy and procedures of the office. Effective appointment scheduling 23

Appointment scheduling procedures. Verbal skills for offering appointments Ø Instead of asking the client when they would like to come in, say: “The doctor can see you on Tuesday at 10: 00 am or 2: 00 pm, which would you prefer? ” Ø Avoid using the word cancellation, say: “ There has been a change in out schedule, and I thought of you. ” Effective appointment scheduling 24

Appointment scheduling procedures. Verbal skills for offering appointments cont’d Ø If the schedule is full do not say there is nothing at that time or the office is booked, instead say: “ That is a very popular time and we book well in advance. Our first available opening is on …. ” Ø If the clinic is closed do not say we are not working that day, instead say: “I am sorry we will not be seeing clients that day. ” Effective appointment scheduling 25

Appointment scheduling procedures. Tracking unscheduled treatment for each dental provider �Tracking all treatment that has been recommended but not yet scheduled helps measure scheduling effectiveness. �If there are short notice cancellations or no shows the DOA can run off a list of unscheduled treatment and begin calling clients. Effective appointment scheduling 26

Appointment scheduling procedures. Tracking unscheduled treatment for each dental provider – How to do it: 1) Run off a list of active clients for each provider. 2) If the client cannot be reached by telephone and more than one attempt has been made, enter the information into the client’s record and generate a treatment required letter. 3) Do not put the client into inactive status unless the client has specifically responded to the letter. Effective appointment scheduling 27

Appointment scheduling procedures. Tracking unscheduled treatment for each dental provider – How to do it cont’d 4) Look at each clients clinical history§ If the client has been seen in the past 6 months do not call § If the client is overdue for an appointment, highlight his or her name and pull the chart. Call for a continuing care appointment. § If the client requires restorative work, show the chart to the dentist. Is there any other treatment that the client requires? § Enter the treatment plan onto the computer. § Call the client to schedule the appointment e. g. “ Mrs. Khan this is Darsiga from David’s Dental Center. David has reviewed your chart and asked me to call you to schedule your appointment for…” Effective appointment scheduling 28

Appointment scheduling procedures. Treating Emergency Clients Ø Sound judgment is needed when scheduling clients for emergencies. Ø Many offices will schedule a 15 min buffer zone to be used for emergencies. Ø Most dental emergencies are not life threatening , however if the client is in pain it is an emergency to him or her. Effective appointment scheduling 29

Appointment scheduling procedures. Treating Emergency Clients – Questions to ask Ø To decide whether it is an emergency (client should come in immediately) or an urgency (client can wait until the next opening) the DOA should ask: 1) “Describe the discomfort and location” – if the discomfort is dull and at a non-specific location, schedule the appointment at the next time slot. -if the discomfort is localized, acute with rapid onset and severe symptoms, consider an emergency. Tell the client to come to the office immediately. Effective appointment scheduling 30

Appointment scheduling procedures. Treating Emergency Clients – Questions to ask cont’d 2) Do you have a fever? ” - A fever is a sign of inflammation. If the client has fever, pain and swelling it is an emergency. Tell the client to come in to the office immediately. Effective appointment scheduling 31

Appointment scheduling procedures. Treating Emergency Clients – Questions to ask cont’d 3) Has there been a trauma to the mouth” If so, please describe it” -if a tooth has been knocked out or has been fractured it is an emergency. -advise the client to control the bleeding by applying and maintaining direct pressure. -transport the tooth wrapped in a wet cloth or in a glass of milk. Do not rinse the tooth. Effective appointment scheduling 32

Appointment scheduling procedures. Treating Emergency Clients – Questions to ask cont’d 4) Do you experience sensitivity to heat or cold? If so, which is the most severe? ” - Sensitivity to heat can indicate an infection is present. - Sensitivity to cold may be because of an irritant such as a loose or cracked filling. - Schedule the appointment as soon as possible. - Tell the client not to apply heat or take aspirin - If swelling and/or fever is present consider as a dental emergency tell the client to come in the office immediately (the tooth could be abscessed). Effective appointment scheduling 33

Appointment scheduling procedures. Block Scheduling Ø Block scheduling may help the practice meet the overall production goals. Ø When done effectively the practice is more productive and will have fewer interruptions in work activity. Ø However, as with any scheduling system, block scheduling should not be rigid. Flexibility should be exercised. Effective appointment scheduling 34

Appointment scheduling procedures. Block Scheduling cont’d Ø Blocking appointments is the process of dedicating a fixed time in the production schedule during which the practice will strive to book complex, lengthy, or higher revenue treatments. E. g. every Monday reserved for crown and bridge preparations. Ø Because these treatments represent a higher potential for revenue, blocking is a scheduling target for performing the type of treatments that will help the practice achieve its financial targets. Effective appointment scheduling 35

Appointment scheduling procedures. Time Management Ø If the dentist is running late, the DOA should tell the client that the dentist has been delayed and approximately how long the delay will be. Ø Client’s who are made to wait for a long time may feel ignored and become angry and impatient. Effective appointment scheduling 36

Appointment scheduling procedures. Time Management cont’d Ø If the client is acknowledged and thanked, they will be more willing to wait if there is a minor delay. Ø If it is impossible for the client to wait, offer to reschedule the appointment and apologize for the inconvenience. Ø Respecting the client’s time encourages the client to respect the dentist’s time. Effective appointment scheduling 37

Appointment scheduling procedures-Late Clients �Important to remind clients about the importance of keeping scheduled appointments. �If the client arrives few minutes late through no fault of his or her own it is courteous to try to see the client. Effective appointment scheduling 38

Appointment scheduling procedures. Late Clients cont’d �If the client arrives 30 or more minutes late, the client should be assigned a new appointment time. �If the client wishes to stay for the appointment it should be clarified that it may not be possible to complete the treatment and the client may have to return. Effective appointment scheduling 39

Question: To schedule appointments effectively what should be considered? Appointment scheduling procedures – things to consider Effective appointment scheduling 40

Keys to maintaining a productive appointment schedule Ø Dedication, commitment and superb communication skills. Ø A complete analysis of the dental practice to determine the potential for financial productivity. Ø Set productivity goals to maximize production yet minimize stress for the dental providers and clients. Effective appointment scheduling 41

How to eliminate no-shows and cancellations forever (adapted from the Journal of the Canadian Dental Association by Sandie Baillargeon) Ø Dental staff assume that if client’s are educated they will not cancel but this is not so – after all people know cigarettes and lots of sugar is not good but they still have it right? Ø So education is only one step. It takes more than education, it takes commitment to action. Effective appointment scheduling 42

How to eliminate no-shows and cancellations forever (adapted from the Journal of the Canadian Dental Association by Sandie Baillargeon) Ø If a client calls to cancel make a big deal out of it. Ø Hear him or her out then say “Oh” “Will you hold for a moment while I get your chart? Or say “I need to speak with the dentist will you hold for a moment while I get your chart” Effective appointment scheduling 43

How to eliminate no-shows and cancellations forever (adapted from the Journal of the Canadian Dental Association by Sandie Baillargeon) Ø Look at 3 things on the chart: 1) The client’s condition 2) The treatment 3) Why they are having it done Ø Now you have all the important information, the client has had time to think about it AND the client thinks you have discussed this with the dentist. and no one wants to make the dentist mad. Effective appointment scheduling 44

How to eliminate no-shows and cancellations forever (adapted from the Journal of the Canadian Dental Association by Sandie Baillargeon) Ø The client has had time to understand that the appointment is important and thinks that you have discussed it with the doctor so it is now a big deal and keeping the appointment will become more important. No one wants to make the dentist mad. Ø Make it hard for client’s to do what you don’t want them to do but don’t quote policy make them see ‘what is in it for them’. Effective appointment scheduling 45

How to eliminate no-shows and cancellations forever (adapted from the Journal of the Canadian Dental Association by Sandie Baillargeon) Ø No-shows: call the client within the first 5 minutes “we are all waiting for you. . you are important to us” Ø Late clients: only see them if the reason why they are late is one that was out of their control and only if it does not interfere with the next appointment. Effective appointment scheduling 46

How to eliminate no-shows and cancellations forever (adapted from the Journal of the Canadian Dental Association by Sandie Baillargeon) Ø New clients: they don’t know you, they are anonymous. To avoid this call them before the appointment, introduce yourself and say for e. g. “Thank you for choosing David’s Dental Centre we look forward to meeting you tomorrow, Is there anything we can do to make your visit more comfortable? ” Ø If an appointment has to be rescheduled, reschedule during usual downtime or at a time less convenient to the client (must send a message that no shows or lateness is unacceptable). Effective appointment scheduling 47

Communication, communication Dramatic changes can occur with just some minor changes in how you communicate with your clients. How to eliminate no-shows and cancellations forever (adapted from the Journal of the Canadian Dental Association by Sandie Baillargeon) Effective appointment scheduling 48

Effective Appointment Scheduling- Summary Ø Ensure appointments are confirmed. Ø Follow a procedure for handling no shows, latecomers and cancellations. Ø Avoid these by reminding clients of their appointments, educating clients about the importance of the appointment , ensuring they have all relevant information e. g. length of appointment, cost etc. With new clients, establish a relationship before their first visit. Ø Track unscheduled treatments. Effective appointment scheduling 49

Effective Appointment Scheduling- Summary Ø Have a procedure to determine emergencies. Ø Do block scheduling of high revenue treatments. Ø Manage time – be sure there is enough time scheduled between each appointment. Communicate with clients if there in a delay. Don’t book more than 3 weeks in advance. Ø Analyze the dental practice to determine reasons for lost revenue, the potential for financial productivity. Ø Last but not least, set productivity goals. Effective appointment scheduling 50