What Features of the Appointment Scheduling System Were Crucial in Capturing "many Grateful Patients"?

1. What features of the appointment scheduling system were crucial in capturing "many grateful patients"?

a. Punctual Appointment Times e.g., being on time: This is perhaps the most crucial feature of the appointment scheduling system were crucial in capturing "many grateful patients" e.g., punctual appointments (e.g. "I see patients exactly at the appointed hour more than 99 times out of 100") result in "many grateful patients." ("We really appreciate your being on time").

b. Organized and Lean Schedule: E.g. in the scenario there were five examining rooms: three examining rooms used routinely, a fourth that reserved for teenagers, and a fifth for emergencies, so the physician doesn't waste time waiting for patients and they rarely have to sit in the reception area, which keeps parents grateful when children do not have to sit and wait with other sick children in the waiting room.

c. Flexible Appointment Scheduling: This is crucial feature that links back to the first point. An appointment scheduling system that is flexible helps to keep appointment on time (99 out of 100) so the physician can accommodate emergencies, latecomers etc. without making patients wait in the catch-up game.

d. Respectful and Convenient Appointment System: E.g. "most people are happy with the way we run it, and tell us so frequently".

2. What procedures were followed to keep the appointment system flexible enough to accommodate a

Scheduling appointments to allow for 20 to 30 patients between 9 A.M. and 5 P.M (on light days), which was flexible enough to accommodate 40 to 50 patients in the same number of hours if the physician had to.

The case scenario describes the specific procedures as follows.

The two assistants (three on the busiest days) have standing orders to keep a number of slots open throughout each day for patients with acute illnesses. They try to reserve more such openings in the winter months and on the days following weekends and holidays, when it is busier than usual. Initial visits, for which we allow 30 minutes, are always scheduled on the hour or the half-hour. If an appointment finishes sooner than planned, they are able to help i a patient who needs to be seen immediately

With these cushion of time to fall back on, the physician has an extra 10 minutes or so to deal with a serious case, knowing that the lost time can be made up quickly. Parents of new patients are asked to arrive in the office a few minutes before they're scheduled in order to get the preliminary paperwork done. At that time the receptionist informs them, "The doctor always keeps an accurate appointment schedule." Some already know this and have chosen me for that very reason. Others, however, don't even know that there are doctors who honor appointment times, so we feel that it's best to warn them on the first visit" (From case handout).

Summarizing these scheduling procedures:

. Keep a number of slots open for three on busiest day e.g. "My two assistants (three on the busiest days) have standing orders to keep a number of slots open throughout each day for patients with acute illnesses. They try to reserve more such openings in the winter months and on the days following weekends and holidays, when busier than usual.

. First visits scheduled for 30 minutes and always scheduled on the hour or the half-hour e.g. if physician finishes a visit sooner, they may be able to squeeze in a patient who needs to be seen immediately.

. Between well checks, if necessary, two or three visits are booked in 15 minutes.

. With these cushions to fall back on, the physician is free to spend an extra 10 minutes or so on a serious case, knowing that the lost time can be made up quickly.

. Parents of new patients are asked to arrive in the office a few minutes before they're scheduled in order to get the preliminary paperwork done. At that time the receptionist informs them, "The doctor always keeps an accurate appointment schedule."

. Informed of policies at firm visit: e.g. Some already know, while others don't even know that there are doctors who honor appointment times, so it's best to warn them on the first visit" (From case handout).

3. How were the special cases such as latecomers and no-shows handled?

For special cases, such as latecomers and no-shows specific procedures were in place.

1. Less than ten minutes late: sees the patient(s) right way and is reminded of what the appointment time was.

2. Ten minutes late: Receptionist phones his home to arrange a later appointment. If there's no answer and the patient arrives at the office a few minutes later, the receptionist says pleasantly, "Hey, we were looking for you. The doctor's had to go ahead with his other appointments, but we'll squeeze you in as soon as we can." A note is then made in the patient's chart showing the date, how late he was, and whether he was seen that day or given another appointment. This helps us identify the rare chronic offender and take stronger measures if necessary (from case scenario).

3. For no-shows that cannot be reached by phone, the following procedures are in place:

First time: noted in the chart. The second time: the same procedure is followed. A third-time offender: Sent a letter reminding him that time was set aside for him and he failed to keep three appointments. In the future, he's told, he'll be billed for such wasted time. Upon return: They enjoy the same respect and convenience as all other patients (from case scenario).

4. Compare and contrast scheduling approaches for the case.

a. Telephone Assistance

No regular telephone hour: Assistants handle calls from parents at any time during office hours. If the question is a simple one, such as "How much aspirin do you give a one-year-old?" the assistant will answer it. If the question requires an answer from me, the assistant writes it in the patient's chart and brings it to me while I'm seeing