The Agency for Healthcare Research and Quality recommends an approach called Open Access Scheduling. Also known as Advanced Access and Same-Day Scheduling, this method allows patients to receive an appointment slot on the day they call, almost always with their personal physician. This model leaves about half of the day open; the other third is booked only with clinically necessary follow-up visits and appointments for patients who chose not to come on the day they called.
The Institute for Healthcare Improvement shares a success story in which a 25-physician, three site primary care group has restructured their appointment scheduling and eliminated patient backlog.
At minimum, you should have at least 1 or 2 walk-in slots available at the beginning of each day, or some other mechanism to handle emergent or urgent situations.
You should also evaluate your office workflow and priority structure.
Flow Mapping – walking the office as a patient and noting observations about your entire visit.
Cycle Time Measurement – measuring and charting the time associated with different parts of the patient visit.
Visit Planning – involves chart preview, enabling the team to identify potential problems that could “derail” the visit.
Huddles – reviewing the schedule and identifying ways to make the day flow better.
Making time for non-visit-related care – phone calls, refill requests, etc. MAs can return calls, convey normal lab results, prescription renewals or information requests via established protocols.
Co-location and cross-training – putting people whose work is related into contiguous spaces to reduce messaging, errors, re-work, and delays.
Streamlining check-in – evaluating forms for focus and design, pre-registration.
Exam room standardization with standard sets of supplies.
Documentation shortcuts and team documentation – condition-specific templates, using check boxes and allowing “documentation by exception.”
Streamlining checkout – providing standardized instruction letters, visit summaries, and boxes to check for tests and consultation requests for common diagnoses.