The scheduling of patient appointments is a complicated task that can lead to frustrations for both patients and physicians. These include cancelled appointments, no-shows, excessive wait times for specific requests (e.g. physical exams) and conflicts with a physician’s other responsibilities, including family, conferences and vacation time.
Having experienced these challenges in her practice at the Riverside Court Medical Clinic, Dr. Lisa Moore implemented a new booking policy, guided by the CFPC Best Advice: Timely Access to Appointments in Family Practice. Her improved booking template included the following:
- Pre-booked appointments from 9:00am-1:30pm, with five bookings per hour;
- Same-day (i.e. advanced access or open access) appointments from 1:30pm-4:30pm, with five bookings per hour;
- Defined booking times for specific appointments, including physical exams and counselling; and
- Limiting bookings to no more than 4 weeks in advance.*
*Some patients are able to schedule further in advance depending on individual need, including those with chronic disease (e.g. diabetics), those who travel extensively for work, and university students who study elsewhere.
The new template necessitated the training of staff members, who had the most difficulty adapting to these changes, and informing patients of the new format. Extra days were also accounted for to address the initial backlog of bookings. Despite the challenges of implementing these changes, this system ensures improved access for all patients to appropriate and timely care, while allowing physicians the necessary flexibility to fulfill additional responsibilities.
Dr. Moore’s initiative is a great example of Quality Improvement in practice. At the Community Retreat on March 24th, 2017, she described her project and provided a testimonial to the impacts of incorporating QI measures into everyday clinical work.