Article Date: 6/1/2013

Business Strategies
business strategies

Are Your Changes for the Better?

Without a baseline measurement, you are making changes at your own risk.



What would happen to a snail mail recall system that changed over to e-mail and text messages? What about a system that uses phone reminders that changes to pre-appointment with text messages? Or how about changing a system that notifies patients by phone when their glasses are ready to be picked up to a system that schedules appointments for pick ups?

There are many examples of “the way we do it in our office,” be it recall or notifying patients about their glasses. Are the way you do things in your office working optimally, and more to the point, what if you want to make changes to how you do things? And how do you change something that has multiple steps?

Where to begin?

Start with a baseline.

For example, let’s say your current recall system sends postcards 11 months after the patient’s last exam. Before making any changes, you need a baseline of how that current system performs. So, if you mail 100 cards for patients who were examined in July 2012, how many will come back in July 2013? I’d use at least three months of data to get this starting number. Once you have that data, then you can start to improve. Any changes are fair game (content, font, card stock, ink color, formatting etc.), and the best way to change a multi-faceted program is usually to change only one thing at a time.

So in this case, if you wanted to change from a postcard to add a phone follow-up and then texting, try the addition of the phone call first. As illustrated above, make the new change for about three months, and track your results. Then, add texting and measure again.

Two accomplishments

Carefully titrating the changes this way accomplishes two things: First, it assures that you make only positive changes. For example, if adding the phone call caused a decrease in response rate, you’d know that you can safely stop making the calls. Second, it controls costs. If the phone calls didn’t work, you would stop them after the three-month test. Then, you’d have the extra money to put toward trying texting.

We worked with a practice that had fairly good success with snail mail recall. The owner was hesitant, as was I, to make any changes. However, we agreed on the supposition that if first-class mail worked well, the more expensive priority option might work even better, or at least cover the extra incremental cost. Our thinking: That more patients would open priority mail envelopes compared with first-class mail. Fewer would be thrown away, and this would result in more patients.

We tested this for three months, and we were wrong. This added investment had no effect on the ultimate patient response rate. If we didn’t compare results with a baseline, we could have easily spent an additional $5 per patient per month ad infinitum. And in this case, that would have been very easy to do, since it appeared on the surface that the response rate should have been better.

Does the above mean that priority mail won’t help your recall system? No. It means the only way you’ll know is if you test it. Your patients might be more or less predisposed to respond. But test you must, or you risk haphazardly making changes at your own peril. OM


Optometric Management, Volume: 48 , Issue: June 2013, page(s): 80