The Family Practice Office
Capacity and Demand
Functional and Dysfunctional choices
and consequences
Matching Capacity to Demand
Deficit
Excess
Deficit
Demand Exceeds Capacity
Capacity Exceeds Demand
Demand Exceeds Capacity
In The Zone
Capacity Matches Demand
Matching Capacity to Demand: Dealing with Deficit
Reduce Demand
Increase Capacity
Matching Capacity to Demand: Dealing with Deficit
Reduce Demand
Reduce Patients
Decrease need for office care
Deflect Demand
Decrease Scope of Practice
Matching Capacity to Demand: Dealing with Deficit
Reduce Demand
Reduce Patients
Close to new patients
Transfer Existing Patients to other practices
Allow dissatisfaction to induce patients to move to
other practices
Matching Capacity to Demand: Dealing with Deficit
Reduce Demand
Reduce Patients
Decrease need for office care
Deflect Demand
Decrease Scope of Practice
Matching Capacity to Demand: Dealing with Deficit
Reduce Demand
Deflect Demand
Telephone Medicine(?)
Emergency Room
Consultation
Admission
Outpatient Queue
Matching Capacity to Demand: Dealing with Deficit
Reduce Demand
Reduce Patients
Decrease need for office care
Deflect Demand
Decrease Scope of Practice
Matching Capacity to Demand: Dealing with Deficit
Reduce Demand
Decrease need for office care
Teach patients more self-care skills
Provide more self-care support(phone, web, email, pt
ed materials)
Find more “time-effective” ways of providing routine
and preventive services in the community
Increase follow-up intervals (?)
Matching Capacity to Demand: Dealing with Deficit
Reduce Demand
Reduce Patients
Decrease need for office care
Deflect Demand
Decrease Scope of Practice
Matching Capacity to Demand: Dealing with Deficit
Reduce Demand
Decrease Scope of Practice
Do Fewer Procedures
Neglect indicated interventions
More “Automatic” referrals
Outsource classes of care
(mental health, OB, office procedures, specialty clinics,
coumadin, cardiology
Matching Capacity to Demand: Dealing with Deficit
Reduce Demand
Increase Capacity
Matching Capacity to Demand: Dealing with Deficit
Increase Capacity
Increase Providers
Reduce rework
Increase non-doctor office visits
Decrease no show rate
Group Visits
Decrease time per visit
Increase time each provider sees patients
Matching Capacity to Demand: Dealing with Deficit
Increase Capacity
Increase time each provider sees patients
Start earlier
End later
Less time off
reduce teaching time
reduce administrative time
Matching Capacity to Demand: Dealing with Deficit
Increase Capacity
Increase Providers
Reduce rework
Increase non-doctor office visits
Decrease no show rate
Group Visits
Decrease time per visit
Increase time each provider sees patients
Matching Capacity to Demand: Dealing with Deficit
Increase Capacity
Decrease time per visit
Eliminate Interruptions
Make data accessible at the point of service
Optimize the physical flow
Provide more assistance(assistants)
Preprocess the patients
Matching Capacity to Demand: Dealing with Deficit
Increase Capacity
Decrease time per visit
Make data accessible at the point of service
Medical references
Formulary resources
Patient education resources
Last dictation
recent labs and x-rays
historical data
Matching Capacity to Demand
Deficit
Excess
Demand Exceeds Capacity
Capacity Exceeds Demand
In The Zone
Capacity Matches Demand
Matching Capacity to Demand: In the Zone
Unrushed
Constant Coverage of Services
Patients’ needs are met
Least Errors
Least Waste
Financial Performance Optimized
New patient care is same as established
Matching Capacity to Demand: In the Zone
Patients’ Needs are met
Patients are scheduled at their convenience
The patient determines the degree of urgency
Logistical needs are just as important as medical needs
(work notes, school physicals)
Educational Opportunities are important visits
(you could have taken care of this yourself at home)
Matching Capacity to Demand: In the Zone
Unrushed
Constant Coverage of Services
Patients’ needs are met
Least Errors
Least Waste
Financial Performance Optimized
New patient care is same as established
Matching Capacity to Demand: In the Zone
Least Waste
Fewer Hospitalizations
Fewer Drugs
Lower cost drugs
Fewer Tests
Fewer Referrals
Fewer Delays and Less Waiting
Fewer Visits
Matching Capacity to Demand: In the Zone
Unrushed
Constant Coverage of Services
Patients’ needs are met
Least Errors
Least Waste
Financial Performance Optimized
New patient care is same as established
Matching Capacity to Demand: In the Zone
Constant Coverage of Services
Office Outpatient care
Hospital Inpatient Care
Telephone Messages
Nursing Homes
Home-bound patients
Emergency Room
Teaching
Matching Capacity to Demand
Deficit
Excess
Demand Exceeds Capacity
Capacity Exceeds Demand
In The Zone
Capacity Matches Demand
Matching Capacity to Demand: Managing Excess
More time off
Salary Reductions
Increase services
Layoffs
Increase scope of practice
Community Outreach
Expand into new markets