Is it possible to shorten patient wait times without adding practitioner hours?

Updated: Oct 4

Adverse outcomes are often associated with longer wait times for primary care appointments and requiring individuals to rely on urgent care. In many cases, a new nonurgent visit with a family practice physician in the US can take up to 20 days. Many practices and clinics have attempted to minimize wait times and improve access to primary care by increasing the availability of family practice physicians or by instituting incentives for physicians to increase the number of evening and weekend appointments they provide. However, increasing the number of available appointments is not generally the most efficient or cost-effective way to answer patient wait times.


The healthcare industry standard metric in determining how long a patient waits to be seen is called the “Third Next Available Appointment” (TNAA). According to Health Team Works, the TNAA is defined as the average length of time in days between the day a patient makes a request for an appointment (i.e. new patient physical, routine exam, or return visit exam) with a physician and the third available appointment. In contrast to first and second available appointments (often the result of last-minute cancellations, working patients into the schedule, etc), the TNAA best represents the overall performance of the appointment system.


In 2017, BMC Health Services Research performed a systematic review of interventions to reduce wait times and found that health systems that were able to implement an Open Access Scheduling plan were able to reduce scheduling delays without adding staffing resources. Open Access Scheduling is based on several principles which favor patient access and focuses on understanding demand and matching capacity. It allows patients to seek and receive health care from their practitioner at the time of their choosing.


Proponents of Open Access Scheduling suggest that it reduces patient waiting times, improves continuity of care, and reduces no-show rates. In the BMC review, their findings identified several studies which demonstrated a decrease in time to TNAA (a decrease which was statistically significant in 5 out of 6 articles where statistical analysis was performed). Additionally, there was an improvement with no-show rates and an increase in patient satisfaction.


However, there are also skeptics of the Open Access system. Many found that changing their scheduling to accommodate more open slots per the Open Access system protocols was difficult to implement and some felt it could potentially reduce the continuity of care negatively impacting those patients, with chronic conditions, who seek regular follow-up.


In many ways, BMC’s review of wait-time interventions highlights the potential opportunity for practitioners to improve access for their patients IF they can implement a system which accommodates available appointments to patients on the day that they call or the time of their choosing. A solution which seemed too good to be true, until the introduction of SkedgeAlert.


SkedgeAlert’s unique appointment matching algorithms provide a plug-in solution to improve a practice’s TNAA metrics. SkedgeAlert’s ability to align patient’s scheduling preferences with same-day and future open slots enables schedulers the flexibility they need to accommodate those patients seeking immediate care and those patients who have limited availability. Unlike Open Access Scheduling, SkedgeAlert alleviates the need to increase practitioners scheduling plans.

SkedgeAlert works with your EHR/EMR systems and automatically finds open slots which already exist, enabling practices to achieve improved 3NAA performance without disrupting current scheduling and operational procedures. With SkedgeAlert, practitioners can finally improve patient access while also improving the performance of their scheduling team.

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