The concept of "doing today's work today" through open access or same-day scheduling has been well known in practice management circles for years, and most practices that have tried it can vouch that adopting this technique increases patient, staff, and physician satisfaction, and decreases no-shows and wasted work.
Despite the rave reviews, open access—reserving a number of appointment slots for same-day appointments—is not wildly popular in practice.
One reason: "To doctors, volume is money. And they look at gaps in the schedule and almost panic," says Dawn Blazier, office manager at My Family Doctor, PC, in Brodheadsville, PA, where she's been using open access scheduling since 2004. "But at the end of the week, you're seeing just as many patients, but the stress is taken out of the schedule."
Further, traditional schedules often leave staff members spending significant time trying to squeeze in patients who need to be seen quickly, says Christine Ingram, a senior consultant with The Coker Group in Alpharetta, GA. For some practices, every day is a struggle to decide how to fit every patient into the schedule. And when this can't be done, patients go unseen and unsatisfied, she adds.
Despite the benefits, open access can go awry if not planned and executed properly. Here are six steps to help ensure open access success:
1. Educate and obtain buy-in. Make sure you have educated your staff and physicians on the reasons for adopting the new scheduling system, says Ingram. Start by clearing up misconceptions, particularly the idea that you'll be giving up control of the schedule.
"Believe it or not, you'll have a more predictable schedule, even though it's not people that you see on paper. Plus, physicians more often get to see their own patients. Patients don't have to see someone who just happens to have an open emergency slot," she says.
What many physicians and staff members may not realize is that open access is fully customizable to each practice's needs. Not all physicians need to use the system, nor do all physicians need to reserve the same amount of open access time. And it's perfectly acceptable—essential, even—to make changes throughout the year due to seasonal volume differences as well as trial and error, Blazier says.
2. Determine the scope of open access that is right for your practice. "Do your homework first," Blazier says. This means keeping a phone log of the number of calls the practice gets each day and the type of appointments requested, and watching trends develop for a few weeks, keeping in mind seasonal variability. "You're going to have to adjust, but you don't want to add 10 hours a week of open access when you only needed six," she says.
Meanwhile, take the time to conduct a quick operations check to ensure you aren't performing redundant front-end processes, such as collecting the same information at more than one time or place. This step will automatically improve the efficiency of your practice and clear the way for a smooth transition to open access, Ingram says.
Also understand that open access may not work for every physician or practice. For example, this type of scheduling is best suited to primary care or specialties that aren't heavily referral based. A doctor who does a lot of surgical consults, on the other hand, is probably not a good fit, Ingram says.
3. Simplify your scheduling codes (reasons for visit). Settle on no more than three to four standard codes, Ingram says. You may also want to standardize the length of each visit, no matter what visit type, she adds.