PTO 147 | Care Plan


Treating patients isn’t just about getting them through the doorYou 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.  


Listen to the podcast here:

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

I want to share with you something that Ive been working on quite a bit with my coaching clients. Something that we use to address issues regarding retention, situations in which maybe theres a busy season or youre expecting a busy season, but youre 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 shes not here anymore. Worst of all“We had a ton of new patients and our total visits arent 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 thats great. Id love for you to share with the other owners what youre doing. Share with me and Ill let other people knowespecially if its a good idea. The issue generally comes up that patients are falling through the cracks. Youve got poor retention effortsor were not doing anything retention-wise to keep patients in the books. Theyre 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 theyre not getting the results that they want. Hopefully, but routinely, it gets back to the physician, That physical therapy clinic didnt 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, theyre 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 spreadsheetlisted all of the active patients and their future appointments with notes available to list any communication efforts that weve made. First onlist 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 theyre 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. Lastlywe would talk about who was formally discharged and informally discharged from that list. Formal discharge was obviously who agreed with the physical therapist that theyre not coming anymore. They popped the champagnegot the coffee mug and t-shirts, they high-fivecelebrity walkthrough, and lead them out the door. They were formally discharged versus those who simply arent returning your calls. Those are the informal discharges. Well 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 goalsThe statistic that were going to try to improve with this is the percentage of completed plans of care. Thats 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 tothat 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. Its lost money, lost revenue, and poor reputations, you name it. Itall 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 were only seeing them one time a week in a typical orthopedic clinic, theyre probably not getting well and not meeting their goals. Theyve got to come 2 to times a weekso 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 lineprofits, and the patients ultimately are getting better. Theyre 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. Were old school. That was how it was back in the day. Now your EMRs can print out some of those sheets. Some of them arent very trustworthydepending 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. Thatthe kicker. 

Heres the secret. This is the front desks responsibility. This is not your responsibility. Your responsibility is to make sure that this meeting happenssame day, same timeevery 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 deskresponsibility. 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 listedall their scheduled appointments. If they dont have any scheduled appointments in the near future, especially the next weeknotes are made as to what their communication efforts have been and where that patient is. Maybe theyre on vacation or something thats happened that they cant 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 ultimatelyfill 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. Youll 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 thuswilling 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 youre not in charge of it. 

Yes, initially youll have to do some training. Youll have to show them what to do and how to do it, but then eventuallythey have to take ownership. This is their responsibility. They are supposed to lead out in this meeting and show you exactly whats 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. Thats my moment for the day. 

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