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Can Fam Physician
Vol. 54, No. 3, March 2008, pp.379 - 383
Copyright © 2008 by The College of Family Physicians of Canada
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Program Description

Same-day booking

Success in a Canadian family practice

Victoria Mitchell, MD
Family physician in Halifax, NS

Correspondence to: Dr Victoria Mitchell, 6155 North St, Suite 200, Halifax, NS B3K 5R3

PROBLEM BEING ADDRESSED Patients in a family practice had to wait 6 weeks for an appointment.

OBJECTIVE OF PROGRAM To improve patient care by facilitating access to timely appointments.

PROGRAM DESCRIPTION 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.

CONCLUSION 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.







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