How to Assess Urgent Care Workflow for Bottlenecks

Germs. Viruses. Bacteria. They wait around every turn to pounce on unsuspecting hosts, who end up weak, tired, unproductive, and in your waiting room. You wipe out the germs and get your patients feeling great and back on track.

In the same way, urgent care clinics are susceptible to germs and viruses of their own that can result in underperformance, wasted time, and increased cost of doing business. But while it’s easy to diagnose and treat patients, determining the bottlenecks in your urgent care and finding the right prescription to fix them is not nearly as simple.

A bottleneck occurs when one process in a chain of processes is performing at limited capacity, reducing the capacity of the whole chain. In urgent care, a bottleneck not only lowers efficiency, it can slow (or stall) your revenue cycle, lower patient satisfaction, decrease morale, and increase pressure from patients who expect a quick and painless urgent care experience.

Most urgent care bottlenecks can be found buried in your processes. The only way to find them is to dive deep into the actions you take at each part of your process—starting at your front desk, in triage, and during the patient exam.

Don’t go it alone. Use our three-part Bottleneck Assessment to find those pesky process problems so you can cure them once and for all.

3-Part DocuTAP Bottleneck Assessment

For each section of this bottleneck assessment, determine your performance in each area based on current data or observation, not your best guess. If you don’t have quick access to data and reports, you may have found your first bottleneck.

Part 1: Front Desk

So many tasks must be completed properly and e­fficiently at the front desk to ensure a smooth workflow through every encounter. This part of the process provides plenty of opportunities for bottlenecks to show up.

Use the following list of questions to identify bottlenecks at your front desk.

Can staff­ complete a new patient registration in four minutes or less?

Can staff­ complete a follow-up reservation in under two minutes?

Does staff­ collect 90 percent or more of patient copays?

What percent of copays is actually collected?

Does staff­ check and collect unpaid account balances?

Is the number of staff­ adequate to maintain smooth patient flow? Is it insufficient?

Is staff­ ratio adjusted based on visit volume throughout the day?

Is staff­ ratio adjusted based on visit volume seasonally?

Is your front desk overstaff­ed?

Is everyone generally busy with tasks?

Is time being managed eff­ectively?

Does staff­ communicate e­ffectively and work as a team?

Do staff­ leave the EMR/PM to complete registration using secondary applications?

Does registration solution auto-populate copay and deductible information?

Does scheduling tool integrate online registration with walk-ins?

Is patient queuing system easy to follow? Adjust?

Is patient queue visible to patients?

Part 2: Triage

Effective triage positively affects satisfaction of patients and providers, shortens the length of each encounter, and reduces overall door-to-door time. At its core, triage is rapid evaluation by an experienced clinician to determine complexity and priority—and determine what happens next. Triage bottlenecks can be an indication of staff ineffi­ciency, but are more commonly caused by process, system, and software issues.

Use the following questions to identify bottlenecks in triage.

Are clinicians documenting on paper, then keying information into the actual EMR?

Do clinicians have access to patient charts on mobile devices?

Are PM and EMR fully integrated to prevent duplicate entry?

Can multiple people access the chart at the same time?

Is free texting utilized properly?

Is free texting used as an alternative to the appropriate software functionality?

Is staff­ properly trained to reduce the use of free texting?

Does staff­ use free texting only when needed?

Are common procedure or clinical pathway lists available?

Part 3: Exam Time

Doctors often view interacting with an EMR as a less-than-valuable use of their time that interferes with patient care. In short, they would rather be treating patients. It can be a diffi­cult trade off—dividing their attention between their patient and the technology, or deferring data entry until after the patient leaves, increasing the hours in their actual workday. Cumbersome interfaces intensify their discomfort. For these and other reasons, it’s not surprising to find bottlenecks at this stage of the process.

Use the following questions to identify bottlenecks during the exam.

Do providers complete all documentation at the time of visit?

Are providers completing charts at the end of the night?

Can providers document patient encounters, order and receive lab results, ePrescribe medication, and refer to another provider within the EMR?

Does EMR o­ffer data entry shortcuts like favorites lists for one-click documentation and discharge lists?

Does EMR o­ffer customizable quick pick lists?

Does EMR o­ffer provider guided templates for common complaints?

Does EMR off­er provider-informed discharge plans?

Bottleneck Resolution

E­fficiency is everything in urgent care. To be successful, remove the bottlenecks in your processes. After you’ve assessed every step in your workflow and processes, you may determine that your urgent care is running smoothly and effi­ciently.

But if bottlenecks are obvious, it’s time to make some changes including the following:

Reallocate or replace sta­ff to ensure you have the right people in the right jobs.

Reassign tasks and duties to ensure everyone on your team is using their strengths to improve productivity and workflow.

Retrain staff­ to use software and other tools available in a way that maximizes eff­ectiveness.

Change policies or implement new ones to hold staff­ accountable and improve consistency in performance.

Change processes to streamline workflow.

Work with your EMR provider to ensure you’re maximizing current software for the best results.

Upgrade to a new software and services solution.


When all the changes to your current staff and processes aren’t enough, it’s time to switch to a software and services provider—like DocuTAP—to help you get on track for success.

This resource was first published prior to the 2019 merger between DocuTAP and Practice Velocity. The content reflects our legacy brands.