Episode 10:
Aligning Urgent Care Hours with Demand

On this edition of Just Checking In, industry expert Alan Ayers discusses how you can align your urgent care operational hours with demand.

Good evening I’m Alan Ayers and I’m just checking in. Tonight I am going to be talking about aligning your urgent care hours with patient demand. So when we think of urgent care we think of a retail business or a retail delivery channel for medicine. And when we think of retail we also think of the 24-hour Walmart Supercenter, the In and Out Burger that’s open til 2am, the Chick-fil-A that’s closed on Sunday. In retail, we know that a core defining feature of a retail brand is its hours. Well, really the same goes for urgent care. Urgent care is all about convenience and accessibility and being available when patients need us. Ideally an urgent care center should be open 24-hours a day. However, the problem that we have in urgent care— as with retail—is that labor is the No. 1 expense item on an urgent care’s profit and loss statement. Unlike a restaurant however, if a restaurant is having a slow evening they’ll point to a waiter, point to a busser and say “You can go home early.” Urgent care centers typically cannot simply send staff home early if the patient demand is not there. So therefore it is really critical when staffing for urgent care that the staffing level and the hours of the urgent care align when patients are using the urgent care center.

We get asked by clients frequently “If we should extend our hours, should we contract our hours…” and the answer really depends on how patients are using the center. So the starting process for setting the hours of an urgent care center or evaluating the hours of an urgent care center is to plot the number of patient visits, the number of arrivals by hour by day per week. And if you do that you’ll find that most urgent care centers see a fairly significant spike first thing in the morning. So let’s say a center opens at 8 a.m., you have patients who can be late for work, they can be late for school, they can’t necessarily miss work or school and often times we find consumer behavior even if a patient is not feeling well in the evening they typically want to sleep on it and come to urgent care in the morning. So most urgent care centers start out the day with a fairly significant spike that can result in extended wait times, create throughput issues, creates patient satisfaction issues particularly when that morning jolt doesn’t really resolve around noon or 1 p.m. Then most centers getting into the afternoon hours you’ll see a flattening—2 to 3 p.m. is typically very slow. Those are ideal times to shift scheduled appointments so anything from a workers comp recheck to a travel medicine consult to a DOT physical. Almost anything where you can steer patients to a specific time of day you’ll typically want to schedule appointments during that 2-3 hour lull in the afternoon just to flatten the ebb and flow of your patient volume. And then most centers we see get a second wind after school and work let out, around 4 and 5 in the evening, and patient volumes are relatively flat until closing. When evaluating patient demand most centers that are considering extending hours look to extending the evening hours. Let’s say you have a center that currently closes at 8 p.m. you are trying to determine whether that center should be open until 9 p.m. or 10 p.m. I would encourage you to look at patient volumes going into the closing hours and identify whether you are seeing a spike up until the close or a gradual decline into the close. If you are seeing a gradual decline into the close that means that your closing time is appropriate, that sometimes particularly evenings and afternoons on weekends we may see a decline of several hours. You might actually have some money losing hours; you might actually want to contract your closing hours. But in most cases if you see a sharp spike into the close that could indicate some pent up demand and in that case if your center closes at 8 and you have patients that have medical needs at 9 p.m. those patients are likely going to the ED or freestanding ED. By extending the hours of your center you can potentially increase your total patient revenue your total patient volume. I would again encourage you towards the end of the day are you seeing a spike into the close or are you seeing a gradual decline into the close. Most of the time when a center is considering extending hours I encourage extending the hours in the morning. So if your center opens at 9 consider opening at 8 and if you are open at 8 consider opening at 7. Granted there are always individuals, particularly if your center does occupational medicine, you just need to get in first thing in the morning and whatever time you are open they are going to be there. More than likely if you open early you will not increase your total visit census however you can flatten that morning spike which can result in shorter wait times, improve throughput, improve patient satisfaction which translates to repeat visits to positive word of mouth.

Again when we consider urgent care, when looking at the operating hours as with all features of your service offering you really need to consider consumer behavior and patient demand you need to have the minimum operating hours to serve patients when they need urgent care. But if you have too many excessive hours that will hit your profitability directly. So success in urgent care really is the balancing of supply and demand, balancing the staffing levels in your center with patient volume and patient utilization of the center. So that’s it for this episode of Just Checking In. If you have any questions I would love to address those on a future episode. Please feel free to email us at Practice Velocity, at the address on your screen. And until next time this is Alan Ayers, Just Checking In.