Ambulatory Access: Improving Scheduling Increases Patient Satisfaction and Revenue.

BACKGROUND: Even before seeing a physician, patients must first gain access to the hospital system. At large hospitals with high patient volumes, access to specialty care can pose a particular challenge. This study examines the effects of specific initiatives to increase clinic capacity, appointment use, and ease of scheduling on both patient satisfaction and hospital revenue. METHODS: In 2017, a task force at a large, multidisciplinary pediatric hospital instituted a number of initiatives to increase patient access to ambulatory specialty clinics. Clinic sessions were standardized to a 4-hour template, and unscheduled, "held" appointment slots were required to be made available ("flipped") 72 hours before the appointment. A patient-centered electronic scheduling platform was also implemented. Patient satisfaction was assessed using Press Ganey scores. Revenue estimates were calculated for increases in "new" and "return" patient appointments. RESULTS: Total new appointment slots increased by over 44 percent, with over 53,000 appointments added annually. The number of held appointment slots declined by 93 percent. A total of 17,996 annual appointments were added in surgical subspecialties, and an additional 14,756 more surgical appointments were completed. Over 2000 appointments were scheduled by means of the online patient portal. Press Ganey "ease-of-scheduling" scores increased from 57 percent to 72 percent over the intervention period. Hospitalwide, these initiatives generated an estimated $8.3 million in revenue opportunity. CONCLUSION: Standardizing clinic sessions and optimizing clinic availability generates new appointment opportunities, improves patient experience, and increases hospital revenue.

The Effects of Session Standardization and Template Optimization on Improving Access to High-Demand Pediatric Subspecialty Care.

A major focus of US health care systems is ensuring timely patient access to subspecialty care. This article describes the experiences of a large children's hospital after implementation of clinic session standardization and template optimization. Outpatient specialty clinic sessions were standardized to 4-hour periods, and all unfilled complex appointment slots were made available for any appointment type within 72 hours of the clinic date. Three high-demand outpatient clinical services achieved increased aggregate potential and completed outpatient appointments over a 2-year period. These improvements were mostly due to an increase in providers and were not always coupled to shorter patient lag times.