A Quality Improvement Intervention to Increase Access to Pediatric Subspecialty Practice

Pediatric Endocrinology and Diabetes.
PEDIATRICS (Impact Factor: 5.47). 01/2013; 131(2). DOI: 10.1542/peds.2012-1463
Source: PubMed


To improve access to new pediatric endocrinology appointments in an urban academic hospital faculty-based practice.

Three strategies were implemented to increase the number of appointment slots: new patient appointments were protected from conversion to follow-up appointments; all physicians, including senior faculty, were scheduled to see 3 to 4 new patients per session; and sessions devoted exclusively to follow-up appointments were added based on demand. The main outcomes for this quality improvement activity were waiting times for new and follow-up appointments, monthly visit volume, the per-provider visit volume, differences in the proportion of new visits, and clinic arrival rates pre- and postintervention.

Thirteen months after the intervention, average wait for a new patient appointment decreased from 11.4 to 1.7 weeks (P < .001) and follow-up appointment wait time decreased from 8.2 to 2.9 weeks (P < .001). Mean monthly total visit volume increased from 284 to 366 patient visits (P < .01) and mean monthly visit volume per provider increased from 36.8 to 41.0 patients (P = .08). New patients were 27% of the visit volume and 35% after the intervention.

Access to our pediatric specialty care clinic was improved without increasing the number of providers by improved scheduling.

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