Practical changes to patient scheduling have been shown to reduce the time it takes to get a doctor's appointment by more than 80 percent, according to a study published in the journal Pediatrics. Researchers at The Children's Hospital at Montefiore (CHAM) found that modest changes like revamping scheduling systems, balancing supply and demand, and developing contingency plans to handle high demand can significantly reduce patient wait times for appointments with subspecialty healthcare providers without adding more physicians.
In some parts of the nation, it can take as long as nine weeks to see a family practitioner, according to a 2012 report that compared wait times in 15 states. Access to specialty care providers often takes even longer.
"By making practical changes to scheduling and managing patient workflow, we were able to reduce the average wait for a new patient appointment from 11 week to two weeks, even with a complex patient population," said Rubina Heptulla, M.D., lead study author and chief of the division of pediatric endocrinology and diabetes at CHAM and Albert Einstein College of Medicine of Yeshiva University.
Dr. Heptulla treats children with type 2 diabetes, metabolic syndrome, hyperlipidemia, and precocious puberty, a complex matrix of conditions that are associated with pediatric obesity. "With obesity at epidemic levels, we are seeing an increase in referrals for treatment. That's why it's important to cut wait times so that we can diagnose and deliver treatment -- some of which may be life-saving -- as soon as possible."
"Our findings also suggest that the quality improvement tools we utilized could have a significant role in addressing the national problem of healthcare access," said Dr. Heptulla.
Researchers analyzed appointment data from January 2008 to November 2011 and conducted detailed reviews of operational data, the scheduling system and the call center that schedules appointments. Each doctor had an allotment of new appointments, but they were often used for follow-up appointments, leaving new patients waiting longer for their appointments. To break this bottleneck, researchers ensured that doctors used the new appointments for new patients and had other staff members manage follow-up appointments.
By keeping the physicians and staff on track with regular team meetings, and monthly meetings with the Medical Director of the Pediatric Ambulatory Sub-specialty Services Dr. Peter Belamarich and The Children's Hospital Montefiore's Medical Director of Quality Dr. Steven Choi, there was a significant improvement and an increase in new patient's visits. There was also a reduction in the time it took to get a follow-up appointment from eight to two weeks.
Dr. Heptulla said this improved efficiency model could be implemented across the health care delivery system to help alleviate barriers and improve access for all patients.
- R. A. Heptulla, S. J. Choi, P. F. Belamarich. A Quality Improvement Intervention to Increase Access to Pediatric Subspecialty Practice. Pediatrics, 2013; DOI: 10.1542/peds.2012-1463
Cite This Page: