According to Transforming Health Care Scheduling and Access, long waits for treatment are a function of the disjointed manner in which most health systems have evolved to accommodate the needs and the desires of doctors and administrators, rather than those of patients. The result is a health care system that deploys its most valuable resource—highly trained personnel—inefficiently, leading to an unnecessary imbalance between the demand for appointments and the supply of open appointments. This study makes the case that by using the techniques of systems engineering, new approaches to management, and increased patient and family involvement, the current health care system can move forward to one with greater focus on the preferences of patients to provide convenient, efficient, and excellent health care without the need for costly investment.

Transforming Health Care Scheduling and Access identifies best practices for making significant improvements in access and system-level change. This report makes recommendations for principles and practices to improve access by promoting efficient scheduling. This study will be a valuable resource for practitioners to progress toward a more patient-focused “How can we help you today?” culture.

Contents

• THE NATIONAL ACADEMIES
• COMMITTEE ON OPTIMIZING SCHEDULING IN HEALTH CARE
• Reviewers
• Summary
  • STUDY CHARGE AND APPROACH
  • LEARNING FROM OTHER SECTORS
  • LEARNING FROM EXPERIENCE AND BEST PRACTICES
  • FINDINGS, BASIC ACCESS PRINCIPLES, AND RECOMMENDATIONS
• 1. Improving Health Care Scheduling
  • INTRODUCTION
  • CONTEXT: VA PHOENIX HEALTH CENTER CRISIS
  • CONTEXT: NATIONAL ISSUES IN ACCESS AND WAIT TIMES
  • COMMITTEE CHARGE AND APPROACH
• 2. Issues in Access, Scheduling, and Wait Times
  • TERMS AND PATTERNS
  • SCHEDULING PRACTICES BY SETTING
  • FACTORS IN SCHEDULING DELAYS AND VARIABILITY
  • BENCHMARKING IN THE ABSENCE OF STANDARDS
• 3. Systems Strategies for Continuous Improvement
  • LESSONS FROM INDUSTRIAL ENGINEERING PRACTICES
  • SYSTEMS STRATEGIES FOR HEALTH CARE SCHEDULING AND ACCESS
  • CHALLENGES AND BARRIERS
• 4. Building from Best Practices
  • EXPERIENCES IN SERVICE EXCELLENCE
  • COMMONALITIES IN SUCCESS
  • CAPACITY IMPLICATIONS
• 5. Getting to Now
  • CAPTURING THE MOMENT
  • COMMITTEE FINDINGS
  • COMMITTEE RECOMMENDATIONS
  • ACCELERATING PROGRESS
• References
• Appendixes
  • Appendix A Background Papers
  • Appendix B IOM Workshops in Brief
  • Appendix C Committee Member Biographies

This study was supported by Contract/Grant No. HHSP23337008 between the National Academy of Sciences and the Department of Veteran Affairs. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the views of the organizations or agencies that provided support for the project.

Suggested citation:

IOM (Institute of Medicine). 2015. Transforming health care scheduling and access: Getting to now. Washington, DC: The National Academies Press.

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.