File first, call second

1. 01

   Count the pile

   Before you change anything, write down three numbers: referrals waiting, the date on the oldest one, and how many arrive on a normal day.

   You will use them on Friday to see what moved.

   • Count referrals waiting
   • Note the date on the oldest
   • Count one normal day of new referrals
2. 02

   Write down what makes a referral urgent

   Ask your clinicians for the short list of findings that make a case urgent. Most clinics land on five to ten. Everything else can wait for a routine call.

   Put the list on one page next to the filing desk. Anyone who files should be able to sort a referral with it, without asking.

   • Get the urgent list from a clinician
   • Print it on one page
   • Pin it where filing happens
3. 03

   Give each queue one owner

   Three queues: filing, urgent calls, routine calls. Name one person for each. On a small team, one person can own two queues, but never at the same hour.

   Filing means: open the referral, attach it to the patient file, mark it urgent or routine, move on. No phone.

   • Name the filing owner
   • Name the urgent-call owner
   • Name the routine-call owner
4. 04

   Leave a note on every file

   When a referral is filed, add one short line to the patient file: appointment type, reason, urgency. Use the notes field or a saved shortcut in the system you already have.

   When the family calls back, whoever answers can book them on the spot instead of looking for the referral.

   • Agree the note format
   • Set up a saved shortcut if your system has one
   • Show the front desk where to find it
5. 05

   Block the day by queue

   File in the morning, call urgent families right after, then work the routine list. Calls go better once filing is done, because every file already says what the patient needs.

   Keep the blocks for one full week before you judge them.

   • Put a filing block in the calendar
   • Put an urgent-call block right after it
   • Put a routine-call block in the afternoon
6. 06

   Call from one script and log every try

   Use the same words on every call and voicemail, and give the family your email address and website so they can answer however suits them.

   Log each attempt on the patient file. Three tries, with an email after each, then the referral goes back to the doctor who sent it.

   • Copy the call and voicemail scripts
   • Agree where attempts are logged
   • Agree the three-try rule with your clinicians
7. 07

   Check the numbers on Friday

   Count the same three numbers again. If the oldest referral is newer and the pile is smaller, keep going. If not, look at which queue is stuck and move hours to it.

   Once the pile is gone, one person can usually file 50 referrals a day. 100 a day is one or two.

   • Count the pile again
   • Compare with Monday
   • Move hours to the slowest queue

of 21 done

See how many days your pile has left. Start the backlog clock.

The words to use on every call. Copy the scripts.

A printable version is on its way.