Rural Health Clinic Operational Assessment Tool
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Questions marked with an * are required Exit Survey
 
 
* Site location name:
   
* Name (of person completing this assessment):
   
* Title:
   
* Phone Number:
   
* E-mail:
   
 
 
 
General Information about your Clinic/Location
 
 
 
What type of practice do you operate at this location?
 
 
 
If you selected "specialty" as a clinic/practice type, indicate specialty type:
   
 
 
 
Are you affiliated with a provider organization?
 
Yes
 
No
 
Other
 
 
 
 
How many patients does your clinic see each day? (total number of patients among ALL providers at your location)
 
 
 
How many providers are available to see patients at this location?
 
 
 
On average, how many patients per day does each provider see at this location?
 
 
 
Which type of staff members do you employ at this location?
 
Medical Assistants
 
Physician
 
RN
 
LPN
 
NP
 
PA
 
Practice Manager/Director
 
Receptionist
 
Clerical Assistant
 
Other
 

 
 
 
How many exam rooms does the clinic/practice location have?
 
 
 
Are all exam rooms organized in the same manner?
 
Yes
 
No
 
Option 3
 
 
Are supplies and equipment readily and consistently available in each exam room?
 
Almost always
 
Sometimes
 
Almost never
 
Other
 
 
 
 
What type of metrics do you collect?
 
Appointment fill rate
 
Cancellation rate
 
No show rate
 
Avg. # of days to next available appointment for new patient
 
Avg. patient wait time (from door to provider)
 
Other
 

 
 
What type of financial metrics do you collect? Ideal metrics: monitoring clinic performance
 
Average charge and payment per visit
 
Adjustments per visit
 
Patient pay balance (amount patients are responsible for)
 
A/R days (accounts receivable)
 
Denial/rejection rate
 
Date of service vs. date of charge entry
 
Other
 
 
 
 
Do you track/monitor chart completion rate (either by provider or clinic-wide)?
 
Yes
 
No
 
 
 
Do you currently collect e-mail addresses from patients?
 
Yes
 
No
 
 
 
Do you ask patients if it is OK to send them text messages to remind them about upcoming appointments?
 
Yes
 
No
 
 
Do you provide a survey or some type of evaluation method for your patients to comment on their experience?
 
Yes
 
No
 
 
What type of patient feedback tool(s) do you currently use?
 
 
 
Pre-Visit Planning
 
Do you engage in any pre-visit planning activities (i.e., chart prep, medication/re-fill review, etc.) Best Practices for optimizing pre-visit planning
 
Yes
 
No
 
 
 
Describe your pre-visit planning process or tasks
More tips for improving pre-visit planning
   
 
 
 
Patient Prepardeness
 
 
Describe any tasks or activities that you engage in as a way of improving patient prepardeness (for example, ensuring patients arrive on time, requested forms are complete, Rx list, etc.)
   
 
 
 
Resources to help influence patient behavior:
 
 
 
Prior Authorization
 
 
 
Describe your current prior authorization process/procedures:
   
 
 
 
Prior Authorization Toolkit (AMA)  

https://www.ama-assn.org/sites/ama-assn.org/files/corp/media-browser/premium/psa/prior-authorization-toolkit_0.pdf

Additional prior authorization resources (videos, guides, tips, etc.):

https://www.ama-assn.org/practice-management/sustainability/prior-authorization-practice-resources
 
 
 
Patient Flow
 
 
 
Do you track/monitor the time providers spend with patients (average "face time" or time providers spend in patient exam room)
 
Yes
 
No
 
 
 
Do patients routinely communicate additional reasons to be seen (beyond their original stated reason for being seen) to their provider?
 
Yes, very often
 
Yes, but not that often
 
No, this is not a problem
 
 
 
If you do track face time with provider, please indicate here:
   
 
 
 
Do you track/monitor cycle time? (time from patient entering the practice at sign-in until the patient leaves the clinic)
 
Yes
 
No
 
 
 
Do you require patients to sign-out/check-out once their visit is complete?
 
Yes
 
No
 
 
 
What activities or tasks are completed during the check-out process? 
   
 
 
If you do track cycle time (or have done so in the past), what is your approximate cycle time?
 
 
 
What is the most significant barrier to improved patient flow?
   
 
 
 
If it were possible, what two changes would you make in order to improve patient flow?
   
 
 
 
What, if any, changes have been made in the past to improve patient flow?
   
 
 
 
Are the work procedures and processes standardized? (is there formal documentation and clarification relating to who does what, when they do it, and how it should be done)?
 
Yes, most of our processes are standardized
 
Some of our processes are standardized
 
We have very few standardized processes in place
 
None of our processes/procedures are standardized and documented
 
Other
 
 
 
 
Phone and Reception Operations
 
 
 
Do you have a phone triage protocol that is formalized (written down and accessible to staff)?
 
Yes
 
No
 
 
 
If you track call volume, how many phone calls per day does the practice receive?
 
 
 
Describe how your practice manages/processes requests for Rx re-fills:
   
 
 
 
What type of phone-related metrics do you monitor/collect?
 
Daily/hourly call volume
 
Average hold time
 
Average length of phone call
 
Phone call type (refills requests, appt. general questions, etc.)
 
# abandoned of calls
 
We don't monitor/collect metrics
 
Other
 

 
 
 
What different types of technology systems do you utilize?
 
Electronic health record (EHR)
 
Scheduling system
 
Desktop faxing
 
Health information exchange
 
Other
 

 
 
 
Chart Prep.
 
 
 
Do you currently track chart preparation errors by type?
 
Yes
 
No
 
 
 
If you indicated that you do track chart errors, what are your most common errors?
 
Chart is missing information
 
Information in wrong location in chart
 
Other
 

 
 
 
Describe some of the challenges/issues that are present related to chart prep.
   
 
 
 
Scheduling
 
 
 
If you track your appointment fill rate - what is it?
   
 
 
 
What is your current no-show rate?
   
 
 
 
Do you remind patients of their appointment day/time?
 
Yes
 
No
 
 
How are patients contacted?
 
Phone (cell or landline)
 
Mailer (postcard, letter)
 
Automated calling system
 
Text message
 
Other

 
 
If you call patients to remind them about appointment time/date, how far in advance do you call?
 
 
 
Do you request information from patients prior to the appointment? (for example, mail out forms to patients to complete prior to visit)
 
Yes
 
No
 
Other
 
 
 
 
Describe any changes that have been made to better manage and/or reduce patient no shows.
   
 
 
Do you track the percentage (or number) of cancelled appointments that are converted to an appointment in which another patient is seen?
 
Yes
 
No
 
Other
 
 
 
 
Information Technology
 
 
 
If you use an Electronic Health Record (EHR), which EHR software do you use?
 
 
 
Patient Portal
 
 
 
Do you use a patient portal?
 
Yes
 
No
 
Other
 
 
 
 
If you indicated you have a patient portal, which functions are you currently using:
 
Scheduling
 
Access of test results
 
Prescription refills
 
Secure messaging
 
Patient education
 
Other