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Registrars at Tampa, FL-based Moffitt Cancer Center have seen a surge in walk-in patients at outpatient clinics for some time. “[There was] such an increase that we put a team together to handle this situation,” says Marion Knott, manager of clinic access.
Clinics see anywhere from one to eight patients a day who simply show up. A few clinic managers, the outpatient nursing director, and Knott created a standardized process to meet their needs.
Often, patients came to outpatient clinics asking to see a clinician right away, but no one was available immediately. Registrars were put in the position of asking these patients to wait without knowing their needs. The team took two steps:
• They defined the term “walk-in.” This term meant different things to different people. It was defined as any patient presenting to the clinic without a scheduled appointment at that particular clinic. “This distinction was important, because many people have multiple appointments on the same day at different clinics,” Knott notes.
• They created a “walk-in form” for all outpatient clinics to use if someone arrives without an appointment. Patients indicate on a checklist the reason for their visit. The completed form is handed to the patient access rep, who determines the next step.
“It really depends what the patient is there for,” Knott says. If they are dropping off documents or want a prescription refilled, staff encourage them not to wait. However, if they are in need of medical attention, the nurse is paged right away.
If the nurse does not respond within 15 minutes, the rep pages the clinic operations manager for assistance. “For all other nonurgent requests, we ask if the patient would like to wait,” Knott says.
Staff note on the form whether the patient is going to wait and give the form to the nurse to assess. On certain occasions, the nurse determines that the patient really needs to schedule a visit with the provider. “If so, they work with the patient access representative to get the patient registered,” Knott reports.
Staff also record the time each walk-in patient presents and what time the nurse sees patient. “The clinic leadership is responsible for each of their staff’s follow-up accuracy and timeliness,” Knott reports.