Innovation and Best Practices in Health Care Scheduling

Service supply chains for population health: Overcoming fragmentation of service delivery ecosystems

“…Scheduling practices affect delays. The difficulties in this area are well known . A central issue is matching capacities to demands.…”

Resources and Capabilities of the Department of Veterans Affairs to Provide Timely and Accessible Care to Veterans

“…Experts have noted the importance of incorporating patient and family perspectives in setting standards for and assessing wait times to ensure that any standard imposed is in keeping with patient and family preferences (Brandenburg et al, 2015). The Institute for Healthcare Improvement recommends that the average number of days between the day that a patient tries to schedule an appointment and the third available appointment for a new patient physical, routine exam, or return visit ("third next available appointment") be the same day for primary care and two days for specialty care (Institute for Healthcare Improvement, 2015).…”

Transforming Health Care Scheduling and Access

“…Scheduling models include the advanced access model, also known as open access or same-day scheduling, in which a sizeable share of the day's appointments are reserved for patients desiring a same-day ap pointment (Murray and Berwick, 2003), and the smoothing flow scheduling model, which uses the operations management technique of smoothing flow to identify and quantify the types of variability in patient flow (demand) and the resources available to different patient groups (supply) (Litvak and Fineberg, 2013). Options that reframe supply and demand include teambased workforce optimization strategies that increase provider capacity by assigning care tasks to appropriate members of the care team, delegat ing certain tasks to non-clinician team members (e.g., Brandenburg et al, 2015), and technology-based alternatives to in-person visits that address patient needs via phone, telemedicine, and/or mobile health units (Charles, 2000;IOM, 2000;Naylor and Imison, 2010).…”

“…The data on access and wait times in health care are limited, and there is a prominent deficiency in research, evidence-based standards, and metrics for assessing the prevalence and impact of these issues (Brandenburg et al, 2015;Leddy et al, 2003;Michael et al, 2013). However, the limited infor mation suggests that similar scheduling challenges are found well beyond the VA/VHA and exist throughout the public and private sectors of the U.S. health care system.…”

“…The committee also enlisted the leaders of five institutions-Denver Health, Geisinger Health System, Kaiser Permanente, Seattle Children's Hospital, and ThedaCare-to report on the strategies, experiences, and results achieved in their respective systems (Brandenburg et al, 2015). The conceptual framework (see Figure 1-1) that was developed by the com mittee to guide its assessment of the factors shaping overall system per formance identifies supply and demand assessments as the anchor inputs, plus major enabling or constraining influences from culture, management, patients-e.g., the leverage contributed by evidence-and theory-based sys tems engineering, enlightened management that creates a culture of change and improvement, and the extent of patient involvement.…”