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Door-to-Doctor Time As An Important Metric For Eye Care Clinics

March 1, 2024
Door-to-Doctor Time As An Important Metric For Eye Care Clinics

A perennial KPI for Emergency Departments all over the world, Door-to-Doctor time (D2D) is increasingly being used in eye care clinics as a reliable metric for determining overall efficiency. D2D is the length of time it takes for a patient to see the doctor after arriving at the clinic and can give you valuable insights into how well your current processes are meeting patient needs and expectations, as well as a measure of practice efficiency. D2D takes into account every step along the patient journey – from check-in, to paperwork, to workups and testing – until that patient receives direct care from the doctor. It is perhaps the most important lead time metric available. Just as a driver would take the most efficient and direct route to arrive quickly at a desired destination, so too should clinics strive to chart the most efficient and direct course for a patient to see the doctor.

Why Door-to-Doctor Time Matters

Long D2D times can impact your clinic in several important ways:

  • Patient Satisfaction. Patients come to see the doctor, so the sooner we can make that happen, the better the patient experience. A patient’s time is valuable and making the journey longer than it needs to be leads to frustration and dissatisfaction.
  • Perception of the Quality of Care. Research has shown that the longer a patient waits (whatever the cause of the delay may be), the lower their overall perception of their provider and the quality of care provided. 
  • Clinic Reputation. Long appointments negatively impact a clinic’s reputation and may deter patients from returning to your clinic or referring your practice to others. 
  • Clinic Profitability. Longer than necessary D2D time means you might be seeing fewer patients than possible given your clinic’s capacity, which, in turn, means potential lost revenue. 

What Causes Unnecessarily Long Door-to-Doctor Time? 

Longer than necessary D2D times go beyond impacting the patient experience and expose inefficiencies in clinic flow. Some delays are unavoidable, but if, as in our driving analogy, the patient journey is littered with speed bumps, potholes, detours and roadblocks, clinics need to revisit their internal processes and procedures to clear the way for a smooth ride. Long D2D times can be caused by a number of factors including: 

  • Long waiting room times that keep patients “idling.”
  • Unnecessary steps in the flow that take time but add no value.
  • Slow patient handoffs caused by a lack of communication among the care team. 
  • A lack of visibility and knowledge about where patients are, what resources are available, and therefore, what actions are needed.
  • Lack of available resources, be it staff, rooms or equipment.
  • Staff proficiency, productivity, and response time. 
  • Scheduling that is not appropriately time-balanced for providers 

Using a Lean Management Approach to Improve Door-to-Doctor Time

If we can determine why the patient journey is taking longer than necessary, we can improve D2D time. Many eye care clinics are turning to Lean management principles and methodology to identify bottlenecks and develop patient flow process changes to reduce D2D. 

A Lean approach seeks to create value with existing or fewer resources and less waste through improved processes. In eye care clinics, it begins by process mapping the entire patient journey – from appointment booking through checkout and payment – to understand current resources and how they are being used. Listing all of the activities required to move a patient through this workflow, as well as understanding their interdependence, creates a process flowchart that identifies things like processing times, where apparent waste exists, key hand-offs within the process, estimated wait times, and more. Capturing and analyzing real-time data allows clinics to gain valuable insights into the efficiency of day-to-day operations and how they impact D2D time. All points at which barriers to efficient patient flow are identified are opportunities for improvement. 

The following data is taken from real-world Visual Clinic clients and shows the impact of reducing D2D times on patient volume:

Door to Doctor

By reducing D2D time, patient flow increases thereby freeing up valuable clinic capacity, so you can see more patients using existing resources. Working with an outside partner like Visual Clinic can facilitate this analysis, but every clinic has the potential to do this work internally. While it may seem daunting at first, it is in fact much easier than you may think and the rewards can be significant. 

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