It is imperative to create a deliberate and actionable plan for reducing backlog. The backlog reduction plan should include the following steps:

1. Gain immediate supply the easy way. Physicians and the care team can review the schedule of patients with future appointments to see if there are ways to meet their needs other than with an office visit. Ask the following questions about patients with future appointments:
   • There's a patient on my schedule next month that I'm seeing today. Can I take care of that patient's needs today so that next month's appointment is not needed?  When I see them, can I safely and effectively extend their return interval? If yes, then I can schedule a return appointment (if necessary) in three to four months.
   • Can this patient's needs be met with a phone call, or by handling the care in a different way such as by compressing multiple follow-ups into one visit? Can this patient be seen by someone else on the care team? 
   • Does this patient really need a scheduled appointment? For example, a patient who only needs a medicine refill, had a recent office visit, is in the hospital, or who sees another provider as their primary physician might have his or her needs met in other ways.
   
   
2. Temporarily add appointment slots and try to do increasingly more of today’s work today.  Preventing new backlog by not putting today's work off into the future involves reducing future demand and gaining supply in the system. Clinics can prevent future backlog by temporarily adding appointment slots to the schedule (e.g., by adding weekend or evening appointments, or extra appointments during the day). Additional staff members are sometimes needed on a temporary basis to reduce the backlog and prevent future backlog from being created. Gaining supply allows the clinic to do more of today's work today, thereby reducing the amount of work that is being put off into the future and preventing new backlog from being created.
   
   
3. Set a start date to begin reducing the backlog and determine an end date when backlog reduction will be completed. By determining these two important dates, you set the pace for backlog reduction. Be careful to gain and add enough supply that backlog reduction is not a prolonged process. It is also important that the pace for backlog reduction is not too rapid to avoid the risk of burning out providers and staff.
   
   
4. Before you start, confer with senior leaders to be clear about organizational support for various options for working down the backlog. For example, will the organization pay overtime? Will there be additional compensation for providers working extra sessions/hours? Are locum tenens (temporary help providers) an option? Can part-time providers add hours? Explore all the options with your leaders before you engage the team members.

Related Measures

Third Next Available Appointment