University Health Services at UT Austin runs a traditional style appointment schedule. Patients book their appointments days in advance usually. Some appointments open up on the same day and can be booked online after midnight. (Our patient population consists of university students so you can bet they are up past midnight). Once the semester picks up however, we find ourselves booked solid for days in advance. Students who want to be seen today are frequently triaged into our Urgent Care facility where they may wait for an hour or longer to see a medical provider.
Recently we have been processing feedbacks (mostly of the complaint variety) from our patients that they want to be seen sooner. They are frustrated that they cannot schedule an appointment when they want one and they are tired of not being seen when they think they need to be seen. In addition, the "Urgent Care" clinic model has sprouted up around us, some in walking distance of campus where students can be seen on demand. Thus we are in the process of implementing an "Open Access" model ourselves.
But what does this mean? In general Open Access scheduling means providing an appointment for any patient on the day they want to be seen. In some places it may be implemented in the form of a walk-in clinic. Patients are seen in the order they arrive. In other places, it may be that there are still scheduled appointment types such as a physical exam or annual but most visit types are seen on demand. In theory this should shorten our backlog of appointments and better meet demand.
The goal would be to have each day carved in half and the third next available appointment will never be longer away then that half day. This will require plenty of data to understand how we are meeting demand now and how our patients are trying to access our services. Some of these will be questions we don't know answers to, for example, how will we ever know who didn't use our services because nothing was available when they wanted it? We won't know what we don't know. It will require a culture shift in our provider staff and nursing staff. It will require more efficiencies from our tools (such as the EHR). It will require ensuring that the right person is doing the right job at the right time. Finally it will require for us to "do today's work today".
Some additional reading from American Association of Family Practice:
Implementing Open-Access
Potential Outcomes of Open-Access
