The Problem
Our health care system is plagued by delays and long cycle times: delays of several weeks for an appointment with a primary care physician or specialist; extended waits when placed on hold; repeated phone calls to obtain a test result or to have a question answered by a provider; wait times of over an hour to see a physician for a scheduled appointment. These delays adversely affect clinical outcomes, patient satisfaction, and costs, often impacting an organization’s ability to attract and retain patients. Health care providers can rid themselves of unnecessary waits for their patients.

The key to improving access to health care services lies in maximizing supply. This can be achieved, without adding costly resources, by predicting and managing patient demand, increasing efficiency in office practices, and streamlining the flow of patients within and between provider settings.*

Better Care Models Exist
In order to have a system in which patients have the opportunity to see their own providers when they choose, each clinic must manage its total resources (supply) to provide care. When the resources are managed well, this creates openness or space in the clinic. In an optimal system of improved access, an organization provides enough openness or space in the clinic (supply) for health services to meet the demand of its patient population at the time the demand occurs.

In contrast to traditional methods of dealing with access, this approach seeks not to control the daily patient demand for care, but rather to predict it and respond to it. This model is based on the principle that when supply and demand are in balance (or equilibrium) there is no need for waits in the system. In traditional systems, demand is divided into urgent and routine. This division creates a delay by creating separate lines (or queues) for different types of patients. Removing the queues removes the delay. An optimal system is designed to eliminate waiting times.

Sample Results

The Veteran’s Health Administration was able to significantly reduce waiting time to the next available appointment by understanding supply and demand and testing and implementing changes to increase supply, reduce demand, and match supply and demand.

CareSouth Carolina (Hartsville, South Carolina, USA) has been able to increase patient self-management by testing and implementing the use of surveys, one-on-one patient interviews, and small focus group visits.

*Source: Murray M, Berwick DM. Advanced access: Reducing waiting and delays in primary care. Journal of the American Medical Association. 2003;289(8):1035-1039.