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Written by: Darlene D'Altorio-Jones (1959-2015) on Monday, May 30, 2011 Posted in: Inpatient Rehab

With a title like that, it most likely didn’t take much time to figure out the topic was scheduling. Scheduling is something innate to all service oriented professions. If it wasn’t, we’d barely know what we were going to do at any given moment. Yet seldom do we think about exactly what should be done to make this very basic yet implicit need provide us with the absolute best options and possibilities.

For some who belong to the largest of systems, a referral may begin “internally” but not necessarily within arm’s reach.  As a matter of fact, large systems often want to capture an opening for the first appointment from a remote location, but rarely have the ability or resources to manage the day-to-day specialized need for scheduling in a rehabilitation environment.

Rehabilitation scheduling is an entirely different animal.  Services in hospital systems usually schedule an appointment for a specific set time but rarely coordinate a series of appointments over several weeks with any pattern or attempt to match a specific provider of that service with the same patient. However, in rehab we do!  It makes us different and makes our needs varied – we live with it.

Internally, we struggle at times to weigh what is best for our practice. Do we centralize the scheduling (communicate to a specific person whose job is mostly to schedule), or do we decentralize and allow each provider of service to tap into the schedule to build, monitor and maintain their own schedule?  If I had the ultimate answer to this question, I could be a genius.  The answer to what is right and in what combination really lies within the department itself.  To be or not to be centralized can present tug of war debates. Is there a rule of thumb? Have there been time studies or best practice models?

I will tell you that a quick search on the Internet heavily weighted toward the virtues of centralized over decentralized scheduling. Not to say that in a pinch, to veer from a standard norm should always be an option from whichever way you practice.  In the articles I reviewed, it became quickly evident that in healthcare specifically, centralized scheduling has bolstered capacity, patient access, maximization of resources, increased market share and patient convenience. Need I say more?

Add electronic capability and systems that handle a range of difficult search options and without a doubt, you can barely argue that the good ol’ hairdresser book and erasable pencils are nearly obsolete but were clever for their time. That option was both centralized and decentralized if you think about it. You came to a central location but just about anyone could place their marks in it.  Despite the inherent virtues paper schedules once had, practicality for managing expensive resources make them obsolete.

Mediware recently hosted a community webinar that spotlighted Burke Rehabilitation’s change from decentralized to centralized scheduling.

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