Scheduling

Physicians/providers

• Stagger in person bookings among doctors in multi-doctor practices so multiple patients are not arriving simultaneously (one doc on the hour, one on 15, one on 30 in a 3 doctor office, for example)
• Change number of providers in the office at the same time

Exam rooms

• Exam room turnover – consider that cleaning products need ‘wet’ time so may not be ready right away
• Number of exam rooms kept “open” (consider one room per PCP to alleviate cleaning duties?)

EMR scheduling

• Create blocks of time when in-person visits can be booked
• Create new appointment types in different EMR (in-person, virtual, telephone, home visit) for schedulers/doctors
• Check with your EMR vendor to refresh training on different booking features
• Consider an online booking platform to free up phone lines for telephone visits

Deciding on appropriateness of virtual vs. in-person appointments

• Virtual care is any care that is not provided face to face, e.g., phone, email, video, etc.
• In person appointments – limit attendance to only those requiring care + one caregiver/assistant if needed
• In a one-hour period, alternate between virtual visits and in-person visits to spread out the time between in-person appointments.
• Solo physicians/small clinics: consider staggering in-person with virtual to allow for room cleaning in between
• Large clinics: consider having each physician pick a designated day to be in office seeing patients and provide virtual care the remainder of the time. One physician in-house could provide same-day access to group’s patients.
• In person visits when phone/video isn’t enough – OCFP
• Questions to consider when booking as in-person, virtual or telephone (based on CPSA recommendations):
  • Is the patient visit urgent/crucial to the patient’s health?
  • Does the patient feel the benefit of therapy exceeds the risk of leaving their home? Would you be putting the patient at risk by asking them to come to the office for something that could be handled over the phone or virtually?
  • Is the medical benefit to the individual patient worth the risk to you and your office staff by having them travel to a community office or health facility?
  • Could further delay in provision of the care or preventative health maintenance result in a worse outcome for the patient?
  • Will offering care in a community setting lessen the burden on hospital facilities?
  • Could scarce resources, like acute care, need to be accessed if the procedure does not go as planned? How will this be coordinated? What impact might that have on limited resources?
  • Will the care provided prevent the need for a patient to access acute care in the foreseeable future?
  • Would a group of peers support the decision of the care being important? Would colleagues perceive these actions as being self-serving, rather than putting the needs of patients, staff and society first? For example, if there was an outbreak related to your clinic or facility, could you justify your decision-making?