Summary
This report is invaluable in the management of the practice flow, while having the added benefit of alerting you, the Practice Owner/Manager, of any potential team member training opportunities. After reading this article, I hope you will see the importance of this report and agree that it has great value to the success of your practice.
Setup
Prior to beginning this process, you must enable the Lightbar Dialog for each location within your practice. To do this, you must have permissions for Edit > Library Items and go to Edit > Setup > Locations. Select the location by checking the box to the left of the location name, and the edit option at the top of the list. Once on the screen that looks similar to the one below, navigate to the Other tab on the upper right side, and check the Enable Lightbar Dialog box. Then Save your work. This must be accomplished for every location within your url.
Workflow Required to Populate the Report
In order for this report to provide you with the necessary information, a specific workflow will need to be performed within the office to capture this information. The customizable nature of Cloud 9 allows each practice to set up a lot of different features. The screens you see in your office may have a slightly different look than the examples, but the concepts will be the same.
The Locator Bar. Each office has a Locator Bar. It may look different from the one shown below. Basically, all of your patients, when you start your day, will be shown in the Scheduled column of the Locator Bar. If they check in automatically from a check in kiosk, or if you manually check them in, they will move from the Scheduled column into the waiting column.
When the assistant who will be seeing the patient moves this patient to the desired chair, the method in which they do so will dictate whether or not the Patient Flow Details Report is populated with the information required.
If the patient (in the Waiting column) is simply dragged to the Light Bar along the right side of the screen, into the chair in which they will be seen, the Patient Flow Details Report will not provide the best possible information. It will still give you some information, but it will not be reaching its full potential. The proper workflow should be this:
Step 1: The patient should show in the Scheduled Column if they have an appointment today at your location. When they check in (either from a self-serve kiosk, or by a front desk professional manually moving them) they will show in the Waiting column. Some offices may label this column differently.
Step 2: When the team is ready to see the patient, they select the patient's name from the dropdown under the Waiting Column Header, and holding down the left mouse button, drag that patient to the seated column header on the locator bar, and release (not directly to the Chair number on the right side in the Light Bar).
Once the patient's name is dropped in the seated column, a screen like the one below will appear.
Step 3: Verify the information that is completed on the form for accuracy and make changes if necessary. Then add the assistant (yourself) from the dropdown list provided.
Step 4: Always remember to Save your work.
As a result of this action, the Patient Flow Details Report will now show the Assistant (When the parameter has been checked to Order by Assistant).
Step 5: If the Assistant profile is set up to automatically open the Treatment Card when the patient is seated, the Treatment Card will be open on the screen, and the patient will appear in the Light Bar down the right side of the screen, as seen below:
Step 6: Once the initial assessment of the patient has taken place, and the Doctor needs to be called to the chair, right click on the patient's name in Chair 1, and the following list of options will appear:
Call Doctor: When the Doctor has a phone number listed under their Employee Profile (Edit>Setup>Employees), selecting the Call Doctor option should change the field to now include a large number, advising the Doctor which chair requested their presence first.
When the Doctor has arrived, the menu should be opened again, and the Doctor is Present option should be selected. That will make the Header of the Chair change color to green, so other team members know where the Doctor is currently at, as shown below.
The using of the Call Doctor and the Doctor is Present options will populate on the Patient Flow Details Report as seen below. Waiting for Doctor time begins when they are called and ends when they are marked as present.
Once the Doctor has completed their tasks with the patient, and leave to attend to the next patient, left click in the chair on the light bar and select the new option that has appeared called Doctor has Left. This populates the second column identified above as the amount of time the Doctor was with the patient.
If your office's layout or size precludes the Doctor from being immediately available, the Text Doctor Option can be used. It will function the same within Cloud 9 but should also alert the Doctor's cell phone with a text as to which chair requires their presence. The Cancel Call option will remove the request for the Doctor's presence prior to their arrival, if the need for them to be there has been removed.
Call Emergency option: When this option is selected, your call for the doctor will take priority over all other calls. Within the Locator Bar, the number one will appear, and it will flash red, alerting all of the need for the doctor's presence. Doctor is Present should then be selected when they are present, so the order can be resumed, and the red flashing will stop. Please follow your internal procedures for when the Emergency button should be utilized.
Step 7: The assistant will complete any actions necessary with the patient and move them from the Seated field on the Locator Bar to the Ready for Checkout (RfC) field. This marks the end of the Asst2 time, and begins the time identified as the patient being ready for checkout.
Step 8: The check-out Clerk makes the patient's next appointment, and when the patient is moved to Dismissed, the timer stops for this visit. This report can be valuable for the tracking of time it takes from when the patient leaves the treatment chair until they leave the office.
Patient Flow Details Report
The Patient Flow Details Report parameters need to be set up in the following manner:
Start Date and End Date: The same day can be used when looking at for one complete day.
Schedule View: In most cases this will be the same as the Location, but in some offices, they may be labelled differently.
Order By: Options are Time, Chair, and Assistant. We recommend ordering by time.
Group By: Options are Appointment Status, Appointment Type, and Assistant. We recommend grouping by Assistant.
The Name of the Assistant is shown on the upper left, immediately under the date requested in the report parameters.
The Appointment Type for which the patient was seen is shown in the identified column.
The Chair in which the patient was seen is shown next.
The Assigned Doctor's Initials are shown in the Doc column.
The Appointment Status Column is next. When viewing this report, the status should always be dismissed. If the patient was not correctly dismissed, the current status will be shown here (so that it can be corrected). If the appointment was not dismissed, the totals and averages will be adversely affected.
This column shows the time of the scheduled appointment.
The Appointment Length column is a reference for how long the actual appointment should take. Appointments which always run long may indicate a need to adjust the appointment length under Edit > Setup > Appointment Types. It may also identify that a specific assistant requires additional proficiency training with this type of appointment, so their efficiency can be improved to be able to complete the appointment within the identified time-frame.
Checkin Time Column shows the time the patient was checked in for their appointment. This occurred either when they utilized the self-service Kiosk to check themself in, or when they were manually checked in by a member of the staff.
The Var column is for Variance. If the number appears in the negative, the patient checked in prior to their scheduled time. If it appears as a positive, they checked in after their scheduled appointment time. You can see in the examples below that the patient 's appointment time was 8:45, but they checked in at 8:16, a full 29 minutes early (shown as -29). In the second example, their appointment time was 8:00 AM, and they checked in at 8:11 AM, 11 minutes late.
The Lobby Time column is essentially the time they were in the Waiting column. The time they sat in the Lobby between when they checked in and when they were escorted back to the chair.
On Deck time may not be used in your practice, but some offices have it set up to identify the time necessary for specific cases. For example, if the Financial Coordinator needs to speak with a Responsible Party about the account balance being delinquent, or any other reason that the patient is at the office but not being treated for a specific reason, the time of that interaction can be tracked.
The Chair Time Column is an aggregated total of the 4 columns titled Asst1 Time, Wait Dr Time, With Dr Time, and Asst2 time. No matter which provider was working with the patient, this is the total time they spent in that chair.
The Ready for Checkout column timestamp begins when the assistant completes all necessary actions with the patient and moves them from the Seated field on the Locator Bar to the Ready for Checkout (RfC) field.
The Total Time Column consists of all of the Chair Time (including the four columns previously identified) plus the Ready for Checkout Time and the Lobby Time. This encapsulates the entire length of the patient's time in the office, from Check-in time to Dismissed time.
Below is an example of a patient flow when fully documented through the process of their appointment.
The appointment time was 1:00 PM, as can be extrapolated from their Checkin Time of 1:03, which was 3 minutes late. They were in the Lobby for two minutes before being placed in the chair. The assistant was with the patient for 39 minutes prior to calling the doctor. They waited for the doctor for 4 minutes, and then the doctor spent 22 minutes with the patient. The assistant then spent 36 additional minutes with the patient, prior to releasing them for the checkout process. The RfC time was nine minutes, for the total time of 112 minutes. The office had scheduled this for 120 minutes, so the time does appear to be adequate in this instance.
Conclusion
When the information is gathered within Cloud 9 appropriately, the Patient Flow Details can be an extremely important report contributing to the efficiency of the practice, while also being able to alert a practice manager to any potential issues within the process of seeing the patient.
As always, if you have any further questions, please do not hesitate to reach out to Cloud 9 Support by emailing us at cloud9support@planetdds.com, or chatting us online using the chat bubble on the lower right at https://cloud9support.planetdds.com/hc/en-us, or giving us a call during our business hours of 8:00 AM EST to 8:00 PM EST at the 1.800.394.6050 option 2.