Question

What are the consequences of using advanced access in multi-specialty clinic? How might these tools be applied to provide same-day scheduling?

Answer 1

Advanced access scheduling: Advanced access scheduling also called as same day access scheduling is a patient visits the health care provider and receives the care on the basis of the choice in order to decrease waiting and to increase continuity of care and patient satisfaction

Impact of advanced scheduling in multispecialty clinic

There are challenges in the getting scheduling because of many factors:

For hospital staff in multispeciality clinic

Firstly, Patient may visit hospital either regular or emergency care in the multispecialty clinic. but, It may increase burden to the staff and health care provider in the organisation. Regular patient may visit their respective physician on routeine visit, additionally the on the same day scheduling patient may visit and cause extra challenges to the hospital, especially to the health care provider. Staff also may need focus previously visited patient and requestion of physician for new patient appointment. It causes extra burden to all staffs

Second challenge is that  physician may need to see more patients in a day in addition to open scheduling patient. It is very difficult for the big institution to carry out if it is applied in big organization. If The approach is implemented by the organization in avoid the delay of care of the patient, the physician may find this difficult and extra burden resulting in stressful situation for the physician

Final challenges when the appointment is exceed the clinical care services, it gives no benefit to the both hospital and patient

For patients

Primary care:

The primary care physician is responsible to consulate the pool of old patient compared to new patient. The number of patient visits the primary care physician are increased on Monday and during winter seasons. Even though the number of patient is increased along with advanced scheduling system affect and cause burden to the primary care physician. The demand of primary care physician is increased because of decreased supply of primary care physician. The primary care physician receives different case of patient. With the increase use of insurance system for health problem, delay of care to the patient are increased. when the hospital has decreased  supply of staff, physician, consequently, it affect the patient care

Specialty care:

Specialty cases may be a cardiovascular, general surgery, eye, ENT, orthopedic, gynecology. Organization receives multiple cases. Each patient is different in case and sometime, may have multiple disorders. Multiple physicians provide care to the different or same patient. Because of above these factors may affect patient care and dely in care. It is important for different specialist to coordinate their care while providing care to the patient. With the use of insurance system, it affects the delay in access of care and diagnostic test which was order for the patient may affect the delay in care. Some of the physician may be absent in the hospital for any reason because of that, patient get suffer because of open scheduling system. even the resident may not well orient in all specialty care, residents get time to practice with all specialty care

Mental health care: patient who seeks treatment for the mental health issue, they should consult first primary care physician before consulting mental health physician if they have insurance systems

Emergency department: Most of the patients are received in the emergency department with any acute illness, before diagnosing the patient. Emergency patient are loaded in acute care, increase waiting time and delay in care.

Inpatient care: if the patient is consulted in the physician office or specialty area, but the waiting is increased because of the lack of available bed in the hospital, process of insurance, to take choice to admit in the hospital, awaiting for the result, lack of available beds in the specialty area, demand of the patients.

. It is applied by means of 6 techniques

1. Demand and supply daily: the organization should measure the demand the and supply of the organization. Institution should measure the demands by identifying number people visit the hospital and supply can be measured by calculating number of physician, staff of the organization

2. Health care team are developed and invited to use open access scheduling system

3. Decrease accumulation: this open access scheduling may take 6 to 8 week. screening procedures are implemented in order to avoid unnecessary visit to the hospital

4. Make appointment a system easier is established by means of making the patient into different criteria. If the patient visit her own physician, if he visit more than one physician, if he has never seen a physician

5. establish eventual plans : hospital has to plan for any substitute physician for any physician absence or if the demand is increased in case of school visit, in case of vaccinations

6. Decrease needless visits: the physician can send mailing system or phone for their patient who has no need of emergency care, to avoid to hospital. Physician can reduce their patient visit by prescribing test for pap smear test or other yearly test. Patient can consult group of patients with same problem and provides health education and treatment

7. develop team care : when the hospital or organization is capable of provide same day scheduling, by means of team approach, assess the effectiveness of the open scheduling system.