Mitchell Victoria
Can Fam Physician. 2008 Mar;54(3):379-83.
Patients in a family practice had to wait 6 weeks for an appointment.
To improve patient care by facilitating access to timely appointments.
An FP from Halifax, NS, implemented advanced access in her practice. Advanced access is a same-day booking system, which has been shown to reduce or eliminate patient backlogs without the addition of resources. Theoretically, it can be put into effect in any practice with a stable backlog (which indicates that supply and demand are well matched). The first step to implement the advanced access system was to clear the existing appointment backlog. During a 6-week "boot camp" period, all prebooked patients and patients who called requesting same-day appointments were seen (between 50 and 60 patients per day). Same-day appointment rules apply to almost all patients. Staff begin accepting calls at 8:00 AM, and patients request the most convenient time available.
Baseline and postimplementation data are not available, as this was not a formal research study. Nevertheless, this FP from Halifax who implemented advanced access experienced the following in her practice: elimination of patient backlog, fewer no-shows, patients' happiness with the system, increase in physician and staff morale, and stability in physician income. Formal feasibility studies and research evaluating patient outcomes, cost effectiveness, and physician and patient satisfaction in a variety of practice settings would help Canadian FPs decide if same-day booking could be successfully implemented in their practices.
在一家家庭诊所,患者需要等待6周才能预约就诊。
通过方便患者及时预约来改善患者护理。
新斯科舍省哈利法克斯市的一名家庭医生在其诊所实施了提前预约服务。提前预约是一种当日预约系统,已被证明在不增加资源的情况下可减少或消除患者积压。理论上,它可以在任何积压稳定(这表明供需匹配良好)的诊所实施。实施提前预约系统的第一步是清理现有的预约积压。在为期6周的“新兵训练营”期间,所有提前预约的患者以及打电话要求当日预约的患者都得到了诊治(每天50至60名患者)。当日预约规则适用于几乎所有患者。工作人员上午8点开始接听电话,患者选择最方便的时间。
由于这不是一项正式的研究,所以没有基线数据和实施后的数据。尽管如此,这位来自哈利法克斯实施提前预约服务的家庭医生在其诊所经历了以下情况:患者积压消除、爽约减少、患者对该系统满意、医生和工作人员士气提高以及医生收入稳定。在各种诊所环境中进行正式的可行性研究以及评估患者结局、成本效益以及医生和患者满意度的研究,将有助于加拿大的家庭医生决定当日预约是否能在他们的诊所成功实施。