The 2015 annual AAHA/IDEXX Laboratories State of the Industry included an analysis of 1,001 clients to determine factors that owners rank as critical in strengthening their bonds with their veterinary hospitals. One was forward booking appointments.
“Forward Booking” appointments is the practice of scheduling the patient’s next appointment before the client leaves the hospital. Forward booking appointments is a relatively common practice for medical re-evaluations with approximately 76% of hospitals reporting this practice, yet recent data suggests that only 11% of veterinary hospitals are utilizing this approach for semi-annual and annual preventive care examinations . What are the barriers to forward booking appointments?1. Perception
My previous role as a technical service veterinarian provided a tremendous opportunity to discuss veterinary business operations and management with a broad range of practitioners and managers. When forward booking appointments came up, the reaction was often negative, with the owner or team member stating, "their clients don't want to do this." According to the State of the Industry report, “6 of 10 pet owners said they would forward book their next appointment before leaving the practice. In fact, nearly half of all pet owners said they prefer to as long as a reminder is given.”
Implementation of forward booking appointments can be overwhelming. Follow these steps to incorporate this practice into your hospital's daily operations:
A. Obtain buy-in from the team.
● Explain to the team that clients want tools to simplify preventive care. Forward booking is one such tool.
● Discuss the findings of the State of the Industry report. Despite our perceptions, the majority of clients are used to this method in their everyday lives (example: human dental appointments) and like it.
● Discuss the benefits to the team in forward booking appointments. Possible benefits include better, more timely care for pets, less overdue reminder phone calls to make (consistently a least favorite staff activity!) and an appointment schedule that runs more smoothly because preventive care visits are scheduled in advance.
B. Ask your team what concerns they have with forward booking appointments? For this system to be successful, the staff must have their worries heard and solutions brainstormed by the team.
C. The hospital must have an appointment schedule that is consistently available one year in advance.
1) Designate a team member to be responsible for inputting the normal hospital operations schedule for the next 13 months.
● Your hospital doesn't use a computer based appointment scheduler? No problem, just purchase the paper scheduling system for the following year.
2) Select a day of the month that that team member will be responsible for updating the schedule so that it is always complete for a year in advance.
● The schedule is updated one month at a time within a designated period.
3) Objections that might arise:
● We don’t know what the doctors’ schedules will be. The hospital appointment schedule is relatively stable. The doctors are routinely scheduled, and adjustments are made to the timetable as needed.
● It takes a lot of time to input the hospital schedule. There is an initial time commitment. Once the schedule is in place for 13 months, it requires minimal time to update it one month at a time.
D. Communicating the new policy with clients
1) Decide who will explain the new procedure to the clients.
● Will this be the responsibility of the technician, customer service representative (CSR) or doctor? Clear communication is critical to success.
● My hospital successfully implemented this process in 2012. What worked well was when the doctors initiated a brief conversation with the clients explaining that we were beginning to schedule preventive care placeholder appointments in advance. The doctors went on to explain that my CSR would schedule that appointment before they left. It was extremely uncommon that any client objected.
2) Decide what will be said when forward booking the appointment:
● When clients understand the “why” behind the recommendation, there is better adherence:
“Mrs. Smith, we are committed to keeping Fluffy healthy and happy. Because animals age faster than humans, regularly scheduled examinations are necessary to detect diseases early. Dr. Hauser would like to see Fluffy in 6 months, which is the first week in February. How does Tuesday, February 2 work?
3) Tell the client that they will receive a reminder two weeks before their appointment. If the appointment is not at a convenient time, rescheduling during the reminder call is easy.
● It is important to ask clients how they prefer to receive their reminders: phone, text, email or postcard, and honor their preferences.
● Design a process for reminding owners. Who is responsible for confirming the appointments? Confirmation is one of the most important parts of forward booking, because non-reminded clients may not show up for the appointment. It is also an important aspect of customer relationships to make these phone calls. Clients don't enjoy missing appointments; the embarrassment they might feel could cause be detrimental to client bonding.
4) Differentiate forward booked appointments
● Use color coding to designate forward booked appointments. It is necessary that forward booked appointments are easily recognizable so that the advance reminder notification occurs two weeks before the scheduled appointment.
● By color coding forward booked appointments, the hospital management can track the number of "no shows." "No shows" are an important metric; above 10% missed appointments would indicate that the reminder process needs to be modified.
● Establish team goals for forward booked appointments, both made, and the percentage kept. Celebrate successes as a team!
When animal health care teams embrace the concept of forward booking, everyone wins. Our patients receive more consistent and timely healthcare; clients are appreciative of the ease of scheduling, and teams benefit from smoother day to day operations with more visits.
EXAMPLE: Procedures Guidelines Forward Booking Appointments
Team member responsible: Sally
1) Initial Action Step: On August 25, 2017, Sally will input the hospital's appointment schedule for the next 13 months, so that appointments could be booked from September 1, 2017, through October 31, 2018.
2) Repeating Action Step: On or around the 25th of each month, beginning on September 25, 2017, Sally will add input an additional month’s schedule, so that on September 25 she will be updating the schedule to include November 2016.
By entering the schedule initially to include 13 months of appointments, clients can appropriately be forward booked for appointments occurring in 12 months.
By designating a particular time of the month for Sally to update the schedule, the process of maintaining adequate appointments for forward booking is ensured.
3) Sally will program color codes for all forward booked appointments in the computer.
3) Doctors explain to clients when they would like to see the pet next and that the appointment will be scheduled by the CSR (customer service representative) before they leave.
4) CSR schedules forward booked appointment.
5) Two weeks before the forward booked appointment, the CSR reminds clients of their appointment, including what services are due. If the client does not confirm the appointment, make two additional contact attempts.
6) The hospital manager tracks the number of forward booked appointments that are kept compared to "no shows." If there are >10% no-shows, modification of the reminder process is needed.
2. Forward Booking Appointments, Partners for Healthy Pets. http://www.partnersforhealthypets.org/Tool_Track.aspx?id=370