Implementing an Open Access Appointment System


Impact Statement: 
Challenged by undesired delays for clinic appointments, high no-show rates, client dissatisfaction, and suboptimal productivity, Macon County Public used QI to implement an open access clinic appointment system that allowed them to schedule appointments within 72 hours for all clients and all clinical programs.

Macon County Public Health (MCPH) has historically scheduled clinics by type of appointment (e.g., family planning, prenatal, Breast and Cervical Cancer Control Program [BCCCP], child health). This created a long wait time to get an appointment for high-demand services, such as family planning appointments, and fostered a situation where there were unfilled appointments and high “no-show” rates for other clinics. At times, professional staff were had unoccupied time, which is obviously not the best economic situation. We aimed to reduce the time it takes for a patient to make a clinic appointment to when they are seen to less than 72 hours by April 1, 2011.

The Open Access Quality Improvement (QI) Team’s first phase of the project was preparing for a week-long Kaizen event. During the preparation phase, the scope of the problem was defined, visits were made to other county health departments that underwent similar changes to their appointment system, and goals were identified.

During the Kaizen event, a state QI consultant facilitated group work such as process mapping, Gemba walks, and brainstorming. The Open Access QI Team decided that this project could not be phased in but, rather, was going to be a situation where a date was selected, at which time the process went live. There was a tremendous amount of discussion preparing for the “Go Live” date of February 14, 2011. The clerical and clinical staff adjusted their processes for scheduling appointments, and nursing staff were cross-trained on the different services that are provided.

The Open Access Appointment System went live on February 14, 2011. At that point, a client could call for an appointment for any service, except for Prenatal Care, and expect to be seen within 72 business hours.

Current appointment wait times are 72 hours or less.

Organization that conducted the QI initiative: 
Macon County Public Health

Bruckner, J. Public Health Quality Improvement Exchange. Implementing an Open Access Appointment System . Wed, 11/14/2012 - 09:58. Available at Accessed April 20, 2024.

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