You can shuffle chairs as needed during scheduled time off, but unplanned sick days—especially during the busy cold and flu season—can throw a major wrench in the works. When you find your practice short staffed, your best defense is a good offense, says Owen Dahl, a medical practice management consultant in The Woodlands, Texas. “You need to plan for it because it’s inevitable,” he says.
Regardless of specialty or practice size, says Dahl, every practice should cross-train its team, giving staff members the skills needed to perform different jobs. Such training not only allows for scheduling flexibility but also helps keeps employees challenged and engaged. “If you’re missing your receptionist, someone else needs to be able to do demographic checks and collect co-pays,” says Dahl, noting that the same is true for back-office responsibilities.
2. Be Proactive
Practices should anticipate pockets of peak demand as well and do what they can to minimize disruption when someone calls in sick, says Sue Houck, a medical practice consultant with Houck & Associates in Boulder, Colorado. For example, she notes, primary care offices are busiest during cold and flu season, which typically runs from December through March. Nonurgent visits for patients with chronic illness and vaccination appointments should be scheduled before or after that busy window, when possible. “You need to plan ahead and predict,” says Houck, noting that the best-performing practices are experts at outreach. “That’s what practices that plan well do best. They don’t wait for patients to come in for their flu shots; they call them and ask them to come get the vaccination in September.”
3. Prioritize Tasks and Create an Action Plan
Office managers must also learn to prioritize, says Rochelle Glassman, president of United Physician Services in Phoenix, Arizona. “The most important things on a day-in-day-out basis are that patients need to get checked in, insurance needs to be authorized, and patients need to see the provider in a timely fashion,” she says. “There are lots of things that don’t need to happen when you’re short staffed.”
At the morning huddle, managers should communicate those priorities and reallocate work as needed, adds Dahl. “No matter how much you plan, inevitably something goes wrong, so you need to build in opportunities to communicate throughout the day,” he says. “Everyone needs to be tuned in,” Dahl notes, not just the individual who is covering for the absent employee. Larger practices may want to assign a coordinator or point person to manage flow. As soon as management is aware that an employee has called in sick, the patient roster should be reviewed by degree of difficulty. “Look at the patients coming in and identify the more complex cases,” says Dahl. “You may see two patients on the calendar who you need to reschedule because you don’t have the support staff to meet that demand.”
4. Call-in for Back-up
It’s equally important to maintain a roster of back-up workers who can pinch hit when needed. Ideally, back-up workers would be former staff members who already know the ropes; for example, an employee who recently retired or a staff member who resigned to raise children. “You want people who have been in the industry so their skill set is still fresh and they don’t need a lot of training,” says Dahl.
From a staffing perspective, Dahl adds that you can buy yourself some wiggle room and reduce your benefit costs by allowing two or more employees to job share one full-time position, leaving you at least one trained person if the other calls in sick.
If you must use a temporary agency (the most expensive option), says Glassman, be sure that the person they provide is familiar with your practice management system. “The challenge with using temps is that practices are all on different EMRs, and if they’re not familiar with your system, it can cause more of a headache than it’s worth,” she says. “The last thing you want to do when you’ve got 50 people in your waiting room is to burden your staff members even more by asking them to train the temp.”
Unplanned absences are inevitable, especially during the busy winter season. With a little advance planning and a commitment to cross-training, though, you can help ensure that patient safety and satisfaction never have to suffer.