Impact of same-day appointments on patient satisfaction with general practice appointment systems

Sampson, Fiona; Pickin, Mark; O’Cathain, Alicia; Goodall, Stephen; Salisbury, Chris

doi:10.3399/bjgp08x330780

Cited by 23 publications

(20 citation statements)

References 7 publications

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“…29 Quantitative pre/post data on satisfaction with the appointment system were presented in four studies (Table 5). 29,31,37,44,45 None showed significant improvement; in one, each 10% increase in proportion of same-day appointments was associated with an 8% reduction in satisfaction (OR 0.92, 95% CI, 0.90 to 0.94). 45 However, a VA survey found that patient satisfaction appeared to be higher at facilities with shorter wait times (p=0.09).…”

Section: Resultsmentioning

confidence: 97%

Advanced Access Scheduling Outcomes

Rose¹

2011

Arch Intern Med

137

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Background Advanced (“open”) access scheduling, which promotes patient-driven scheduling in lieu of pre-arranged appointments, has been proposed as a more patient-centered appointment method and has been widely adopted within the United Kingdom and Veterans Health Administration and among U.S. private practices. Objective To describe patient, physician and practice outcomes resulting from implementation of advanced access scheduling in the primary care setting. Data Sources Comprehensive search of electronic databases (MEDLINE, Scopus, Web of Science) until August 2010, supplemented by reviewing reference lists and gray literature. Study Selection Studies were assessed blinded and in duplicate. Controlled and uncontrolled English-language studies of advanced access implementation in primary care were eligible if they specified methods and reported outcomes data. Data Extraction 2 reviewers collaboratively assessed risk for bias by using the Cochrane Effective Practice and Organisation of Care Group Risk of Bias criteria. Data were independently extracted in duplicate. Data Synthesis 28 papers describing 24 studies met eligibility criteria. All studies had at least one source of potential bias. All 8 studies evaluating time to third next available appointment showed reductions (range of decrease 1.1–32 days) but only 25% (2/8) achieved a third-next-available appointment <48 hours. No-show rates improved only in practices with baseline no-show rates >15%. Effects on patient satisfaction were variable. Limited data addressed clinical outcomes and loss to follow-up. Conclusion Studies of advanced access support benefits to wait time and no-show rate. However, effects on patient satisfaction were mixed and data about clinical outcomes and loss to follow-up were lacking.

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Section: Resultsmentioning

confidence: 97%

Advanced Access Scheduling Outcomes

Rose¹

2011

Arch Intern Med

137

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“…177 A recent study found that patients receiving same-day care were likely to be in work and have a higher educational status. 176 Sampson 177 found differential levels of satisfaction with appointment mixes by age and by deprivation of practice population and concluded that it is important to accommodate the requirements of different patient groups by allowing both pre-bookable and same-day appointments; Sampson's conclusions echo those of earlier studies. 176,178 A further line of explanation for lower levels of attendance among deprived patient groups relates closely to the issues of patient-provider communication, therapeutic alliance and engagement discussed in section Patient-provider 'alliance', communication and 'engagement'.…”

Section: Explanations and Implications For Remindersmentioning

confidence: 99%

“…174,175 The availability of same-day compared with advance appointments and the potential for such appointment mixes to affect different groups of patients differentially has also been raised. [176][177][178] It has been suggested that patients in deprived areas are more likely to use same-day appointments. 177 A recent study found that patients receiving same-day care were likely to be in work and have a higher educational status.…”

Section: Explanations and Implications For Remindersmentioning

confidence: 99%

“…[176][177][178] It has been suggested that patients in deprived areas are more likely to use same-day appointments. 177 A recent study found that patients receiving same-day care were likely to be in work and have a higher educational status. 176 Sampson 177 found differential levels of satisfaction with appointment mixes by age and by deprivation of practice population and concluded that it is important to accommodate the requirements of different patient groups by allowing both pre-bookable and same-day appointments; Sampson's conclusions echo those of earlier studies.…”

Section: Explanations and Implications For Remindersmentioning

confidence: 99%

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Targeting the Use of Reminders and Notifications for Uptake by Populations (TURNUP): a systematic review and evidence synthesis

McLean

Gee

Booth

et al. 2014

Health Services and Delivery Research

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BackgroundMissed appointments are an avoidable cost and a resource inefficiency that impact on the health of the patient and treatment outcomes. Health-care services are increasingly utilising reminder systems to counter these negative effects.ObjectivesThis project explores the differential effect of reminder systems for different segments of the population for improving attendance, cancellation and rescheduling of appointments.DesignThree inter-related reviews of quantitative and qualitative evidence relating to theoretical explanations for appointment behaviour (review 1), the effectiveness of different approaches to reminding patients to attend health service appointments (review 2) and factors likely to influence non-attendance (review 3).Data sourcesDatabase searches were conducted on Allied and Complementary Medicine, Cumulative Index to Nursing and Allied Health Literature Plus with Full Text, The Cochrane Library, EMBASE (via NHS Evidence from 1 January 2000 to January/February 2012), Health Management Information Consortium database, Institute of Electrical and Electronics EngineersXplore, The King’s Fund Library Catalogue, Maternity and Infant Care, MEDLINE, Physiotherapy Evidence Database, PsycINFO, SPORTDiscus and Web of Science from 1 January 2000 to January/February 2012. Supplementary screening of references of included studies was conducted to identify additional potentially relevant studies. Conceptual papers were identified for review 1, randomised controlled trials (RCTs) and systematic reviews for review 2 and a range of quantitative and qualitative research designs for review 3.MethodsWe conducted three inter-related reviews of quantitative and qualitative evidence, involving a review of conceptual frameworks of reminder systems and adherence behaviours, a review of the reminder effectiveness literature and a review informed by realist principles to explain the contexts and mechanisms that explain reminder effectiveness. A preliminary conceptual framework was developed to show how reminder systems work, for whom they work and in which circumstances. Six themes emerged that potentially influence the effectiveness of the reminder or whether or not patients would attend their appointment, namely the reminder–patient interaction, reminder accessibility, health-care settings, wider social issues, cancellation and rebookings, and distal/proxy attributes. Standardised review methods were used to investigate the effectiveness of reminders to promote attendance, cancellation or rebooking across all outpatient settings. Finally, a review informed by realist principles was undertaken, using the conceptual framework to explain the context and mechanisms that influence how reminders support attendance, cancellation and rebooking.ResultsA total of 466 papers relating to 463 studies were identified for reviews 2 and 3. Findings from 31 RCTs and 11 separate systematic reviews (review 2 only) revealed that reminder systems are consistently effective at reducing non-attendance at appointments, regardless of health-care setting or patient subgroups. Simple reminders that provide details of timing and location of appointments are effective for increasing attendance at appointments. Reminders that provide additional information over and above the date, time and location of the appointment (‘reminder plus’) may be more effective than simple reminders at reducing non-attendance and may be particularly useful for first appointments and screening appointments; simple reminders may be appropriate thereafter for most patients the majority of the time. There was strong evidence that the timing of reminders, between 1 and 7 days prior to the appointment, has no effect on attendance; substantial numbers of patients do not receive their reminder; reminders promote cancellation of appointments; inadequate structural factors prevent patients from cancelling appointments; and few studies investigated factors that influence the effectiveness of reminder systems for population subgroups.LimitationsGenerally speaking, the systematic review method seeks to provide a precise answer to a tightly focused question, for which there is a high degree of homogeneity within the studies. A wide range of population types, intervention, comparison and outcomes is included within the RCTs we identified. However, use of this wider approach offers greater analytical capability in terms of understanding contextual and mechanistic factors that would not have been evident in a more narrowly focused review and increases confidence that the findings will have relevance in a wide range of service settings.ConclusionsSimple reminders or ‘reminder plus’ should be sent to all patients in the absence of any clear contraindication. Other reminder alternatives may be relevant for key groups of patients: those from a deprived background, ethnic minorities, substance abusers and those with comorbidities and/or illnesses. We are developing a practice guideline that may help managers to further tailor their reminder systems for their service and client groups. We recommend future research activities in three main areas. First, more studies should routinely consider the potential for differential effects of reminder systems between patient groups in order to identify any inequalities and remedies. Second, ‘reminder plus’ systems appear promising, but there is a need for further research to understand how they influence attendance behaviour. Third, further research is required to identify strategies to ‘optimise’ reminder systems and compare performance with current approaches.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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“…However, the patients in the studies were subjected to a discrete choice element; more immediate access (capacity) was offset by a reduction of convenience like lack of appointments that can be booked in advance or choice of practitioner. [24][25][26][27][28][29][30] The current study differs as the questionnaires do not have a discrete choice element: the capacity was additional and did not reduce convenience. This could explain why increased convenience did not influence satisfaction in this study where it did in the other studies.…”

Section: Competing Interestsmentioning

confidence: 99%