Practice Perspective – Data-Based Management’s Effect on Staffing and Duty Allocation

By Joseph Mathews

How much is just enough? This is an ongoing conversation for practices regarding staffing as we face lower profit margins, increasing overhead and patient populations that demand both quick processes and high levels of customer service. However, this conversation and the decisions that follow can become less tedious and stressful if practices can begin to use data as their guide.

Using benchmarks from MGMA (Medical Group Management Association) and orthopedic-specific resources like AAOE (American Alliance of Orthopaedic Executives) and OrthoForum/OrthoConnect, our practice has not only established certain service levels for our scheduling departments (as mentioned in the previous article), but we have used collected data to determine the appropriate staffing levels and duty allocations. As a result, we assess these levels on a regular basis.

Benchmarking suggested that one full-time staff member should be able to handle 70 to 80 calls with full patient registration each day. Using the reporting features of our new, comprehensive phone system, we are able to assess call volume on a daily basis and develop strong reporting models that help identify trends that dictate the practice’s needs. For example, we are able to determine that normal monthly call volume is 8,000 to 10,000 calls, which averages to 400 to 475 calls per day in a 21-day working month. Benchmarking standards then determine that in the busiest month we will need roughly five to six full-time staff to cover this volume. However, the data allow us to dig even further.

Daily data collection assesses specific trends for each working day to establish our busiest and slowest periods. This allows for more finite assessment of practice staffing needs per day. For example, we determined that Monday, Tuesday, and Wednesday are our busiest call volume days, and this requires the six full-time staff members to function in our appointment cue. However, Thursday and Friday often only necessitate five staff members. So, what are we to do with the other staff member?

This data need-based assessment allows for staffing models that specifically account for these volume changes by hiring only five full-time staff and one part-time staff to cover the busier days. Another option would be to cross train other available staff in medical records or associated departments and management to assist on the busiest days by offloading other duties or stepping into the cue to field calls. These assessments can be completed as frequently as is deemed necessary – the data are readily available. That may mean monthly or when turnover and rehiring occurs, but it allows for better decision making that combats some of the challenges that practices face.

Data-based management helps to take out the guess work and establishes clear standards for the staff necessary to efficiently manage workloads and allocate duties. This also helps accountability as we expect our staff to perform at a service level (calls answered by a live person in the first minute) at 90 percent or better; and we want to “right size” the department by helping them to achieve the quality metric required. We’ll have more about service levels in future articles.

Joseph Mathews, PT, DPT is the practice administrator for Advanced Orthopaedics and Sports Medicine in the Houston area. In addition to serving on the Texas Orthopaedic Association’s Board of Directors, he serves on the American Association of Orthopaedic Executives’ Advocacy Council.