Improving Patient Access: Everett Clinic

Everett Clinic (Washington, USA) implements Open Access through IHI's IMPACT Network and reduces the time for the third next available appointment to within 24 hours.
The Everett Clinic’s first attempt at improving patient access in 1999 was moderately successful, but it did not produce the results the clinic wanted. So, in June 2002, the clinic intensified its efforts by joining IHI’s IMPACT network. Now, its success is unmistakable: the third next available appointment (a standard measure of appointment access) is usually within 24 hours of a patient’s call.



“This is something that from a customer service point of view is outstanding,” says Karen Nardinger, RN, a clinical practice manager at the 200-physician clinic that has nine locations in Washington State. “I can’t say enough good things about it.”


In its first attempt in 1999, the clinic implemented a “carve-out” model of advanced access, whereby a number of times each day were saved for same-day appointments. “Despite some improvements, we still had long waits for routine or non-urgent appointments,” Nardinger says. “So, the clinic decided to implement the pure model of advanced access, which allows you to offer patients any type of appointment within two days.”
The first site to implement the model was the 12-physician Everett Clinic at Harbour Pointe in Mukilteo, Washington. In September 2002, it was taking 15 days to get an appointment with the family practice physicians at Harbour Pointe. By September 2003, the wait was down to less than one day. In December 2002, a patient needing an appointment with a Harbour Pointe pediatrician had to wait five days. By September 2003, the wait was less than a day. 


“It has a brought a reduction in chaos to our day,” Nardinger says of advanced access. “Days are more controlled and our patient satisfaction scores have risen about 30 percent.” Now the clinic is working to spread the open access approach to other primary care sites and to the 100 specialty care physicians in the clinic as well.
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