The Intake

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How to take control of your schedule and avoid appointment overrun

Scheduling mishaps have serious consequences for providers and patients alike.

appointment overrun

At a Glance

  • Appointment overruns, which 68% of providers experience, impact both patient care and practice revenue.
  • Implementing efficient scheduling systems and pre-appointment processes, such as patient portals and automated reminders, can significantly reduce appointment delays.
  • Effective time management, delegating administrative tasks, and strategic use of space and telemedicine are crucial strategies to prevent appointment overruns and enhance practice efficiency.

Appointment overruns are incredibly common, with 68% of independent providers saying they may have to cancel or reschedule appointments up to 10 times a month. These scheduling mishaps have serious consequences for providers and patients alike.

Regarding patient care, one study found that appointment delays can lead to frustrated patients, dissatisfaction, and a negative experience with their healthcare provider. It can also lead to patients failing to seek medical care.

The impacts aren’t much better for providers, who face decreased efficiency and revenue loss. Appointment overrun leads to shorter patient interaction time, poorer patient outcomes, and lower job satisfaction. 

In other words, no one wins when appointments are overdue. But what can you do to stop or reduce appointment delays?

In this article, we’ll cover:

  • Common reasons for appointment overruns
  • How to optimize your scheduling and pre-appointment process
  • Strategies for managing appointment flow
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Understanding why patient appointments run over

Appointment overrun is a serious problem. In a recent Tebra survey, 59% of respondents reported having appointments that extended past the scheduled time. And this is a common challenge across the industry. The following providers reported frequent appointment overruns:

  • Primary care (64%)
  • Mental health (32%)
  • Specialists (84%)
  • Nurse practitioners (55%)

To figure out how to fix this problem, we need to know the root causes. Our recent survey on patient interaction time highlighted 3 primary reasons for appointment overruns:

  • Patient questions (85%)
  • Late arrivals (69%)
  • Incomplete information (53%)

While you can't fully control these hurdles, you can mitigate them with the right planning and tools. Doing so is critical for long-term practice efficiency and provides satisfaction because appointment overruns can rapidly throw a practice’s time and workflow off course.

For example, even one delayed appointment can lead to rushed visits with subsequent patients as the provider attempts to compensate for lost time. This, in turn, can lead to a loss in patient relationships as interaction time decreases. In the worst-case scenario, rushed visits could lead to misdiagnosis or incorrect prescriptions.

But rushed appointments also hinder administrative staff, who must try to appease waiting patients while maintaining their regular duties. 

The good news is that there are steps you can take to minimize or eliminate regular appointment overruns.

How to enhance patient preparation

The first step to reducing appointment overruns is ensuring that patients understand the pre-appointment process. Explaining your pre-appointment intake and streamlining it via technology can make it easier for patients and providers. 

Provide clear instructions via email or your patient portal before appointments. Pre-visit questionnaires, educational videos, QR code check-ins, and similar options all simplify the process without sacrificing accuracy or compliance. 

The patient portal is the most common tool for instituting these changes. It stores educational content, past intakes, medical records, and other personal data. If you don't currently have a patient portal, Tebra can help you implement one. You can also send automated email and SMS reminders with appointment instructions. In addition, you can use checklists on these platforms or your website to help guide patients.

However, there are many other tactics that can streamline different parts of the appointment process. 

Implementing efficient scheduling systems

Another key component to reducing overruns is implementing an efficient scheduling system. The days of call-in appointments and paper schedules are disappearing. Instead, it’s time to turn towards advanced scheduling tools like integrated calendars that allow for easy appointment booking, rescheduling, and cancellation. 

These tools work together with patient portals to streamline the appointment process without the risk of double booking or missed appointments. They also empower patients.

It’s time to turn towards advanced scheduling tools. ”

In particular, it can be helpful to implement a self-serve scheduling option. A study on web-based scheduling in primary care found that this approach can improve finalizing appointments and enhance the patient experience.

Furthermore, schedulers can send automated reminders via SMS or emails at different intervals and frequencies. This reduces no-shows and late arrivals, which prevents paperwork delays and appointment overruns.

It can also be helpful to open up advance scheduling. For example, you can book annual visits after each appointment, ensuring you allocate time to returning patients and give them enough time to save or change the date if something comes up. 

Adding last-minute cancellation or no-show fees can also deter unexpected schedule changes. Just make sure to communicate the fees clearly to patients in advance.

Strategies for managing appointment flow

Another aspect of reducing overruns is proper time management. For example, it’s critical to set realistic appointment times and stick to them. 

As providers report seeing more patients, it can be tempting to consider shorter appointments. However, this reduces time spent building trust and relationships with patients and answering their questions. Shortening appointments may lead to overruns and patient turnover due to mistrust.

Time management tips

One way to improve appointment times is to average how many minutes you currently spend with each patient — then add 20% buffer time. This offers a few extra minutes to offset questions, late arrivals, and similar issues. 

It’s also important to handle disruptions efficiently. Set up strategies for answering patient questions and preventing late arrivals. For instance, you may decide to tell a patient to arrive 15 minutes early. In addition, you may have treatment sheets available for common diagnoses in your specialty that you can distribute after a visit. This can help offset patient questions without sacrificing patient interaction. 

It is incredibly important, however, to always set a specific time when booking an appointment and sending reminders to patients. Failing to highlight the appointment time can lead to late arrivals.

Delegation and outsourcing

It can also be helpful for providers to delegate administrative tasks to support staff. This can free up time for patient care. In addition, you can train staff to assist with patient preparation and follow-ups. 

For example, in-house staff should learn how to prepare exam rooms, manage supplies, and file paperwork. This can eliminate pre- and post-visit tasks and free up time for patients. 

That’s not all. Research published in the Healthcare Manager reported that teamwork and collaborative efforts within a clinic to manage scheduling guidelines and reduce patient backlogs can improve efficiency. 

In addition, outsource billing, marketing, and other activities to staff members or contractors to further save time.

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Using space strategically

Depending on your practice, you may use different examination rooms to space out pre- and post-visit work. This process can prevent your waiting room from being filled without putting additional time constraints on the practice. However, this works better if you complete vitals, labs, and similar tasks in-house. 

You may also decide to keep an extra room for potential overbookings, emergencies, or last-minute walk-ins. 

Telemedicine as an alternative to in-person visits

You may choose to offer telemedicine as an option. This can be helpful if a patient will be late for an in-person appointment but can be on time from their computer or phone. Furthermore, telemedicine is especially useful for primary care check-ins with regular patients or mental health sessions. 

A 2023 study on the use of telemedicine found that it not only decreased patient waiting room time and reduced appointment delays but also improved schedule management for providers. 

Consider your fill rate

A fill rate estimates how close your practice is to maximizing the number of patients seen. The American Academy of Family Physicians (AAFP) suggests aiming for a rate of 90–95%. Calculate this number for your practice by dividing the total number of appointment slots by the number of slots available for scheduling. The total number of appointments should include double bookings. 

Too low a rate can impact your revenue, but a high number can create stress and reduce buffer time between appointments.

Monitoring and adjusting your schedule

Another helpful tactic is to regularly review the schedule, usually once a week, to adjust based on feedback and data.

The right scheduling software can provide comprehensive data on appointments. For example, with robust data collection and analysis, you can identify overrun patterns and determine potential causes. As a result, you can implement changes to improve scheduling efficiency.

However, just giving your team access to the data isn’t enough. It's also important to set time aside every week or month to review overall trends and brainstorm solutions. 

Streamline your practice management

It’s clear that appointment overruns strain independent practices — but they aren’t inevitable. As a provider or practice partner, you can optimize your schedule and streamline visits. 

Leveraging time management skills, automation, and patient education tactics can help you refine the appointment flow without adding more to your workload. This proactive approach can enhance patient care and practice efficiency. And boost job satisfaction. After all, what’s a better experience than being able to go home on time after a day of successful appointments?

However, it helps to have the right tools. Tebra’s patient experience software offers independent practices the ability to streamline your practice management through:

  • Online scheduling
  • Automated reminders and confirmations
  • Digital patient intake
  • Multiple options for patient communication
  • Patient surveys
  • And more

Discover more features to optimize your practice in a demo or learn more about eliminating no-shows in our recent survey.

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Kelsey Ray Banerjee

Kelsey Ray Banerjee is a professional content writer in the healthcare, marketing, and finance space. She has worked in the back office of a psychiatric practice, and with family members working in mental health for 2 generations, she understands the challenges healthcare professionals face when it comes to marketing and admin. She believes access to efficient healthcare is essential for society’s well-being, and loves being able to write content that can positively impact a practice and its patients.

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