Download - Access to Care
Access to CareAccess to CareAccess to CareAccess to CareBeaufort Pediatrics - Beaufort, SCBeaufort Pediatrics - Beaufort, SCBeaufort Pediatrics - Beaufort, SCBeaufort Pediatrics - Beaufort, SC
Who Is Beaufort Pediatrics?Who Is Beaufort Pediatrics?Who Is Beaufort Pediatrics?Who Is Beaufort Pediatrics?
Single specialty group practice with 4 full time physicians, 1 full Single specialty group practice with 4 full time physicians, 1 full
time nurse practitioner, 2 half time physicians, and Francistime nurse practitioner, 2 half time physicians, and Francis
Office hours 7:30 AM - 7:00 PM, Saturday 9:00 AM - 1:00 PM, Office hours 7:30 AM - 7:00 PM, Saturday 9:00 AM - 1:00 PM,
with general and well child areas.with general and well child areas.
Staggered schedule: 1st physician starts at 7:30, 2nd at 8:30, Staggered schedule: 1st physician starts at 7:30, 2nd at 8:30,
remainder start at 9:00 except for the on call physician who remainder start at 9:00 except for the on call physician who
starts at 10:00. Part time physicians with variable start times. starts at 10:00. Part time physicians with variable start times.
Post call physician does not work. Post call physician does not work.
Each full day has 32 appointment slots with various rules for Each full day has 32 appointment slots with various rules for
the number of slots allotted to specific types of appointmentsthe number of slots allotted to specific types of appointments
Who Is Beaufort Pediatrics?Who Is Beaufort Pediatrics?Who Is Beaufort Pediatrics?Who Is Beaufort Pediatrics?
Single specialty group practice with 4 full time physicians, 1 full Single specialty group practice with 4 full time physicians, 1 full
time nurse practitioner, 2 half time physicians, and Francistime nurse practitioner, 2 half time physicians, and Francis
Office hours 7:30 AM - 7:00 PM, Saturday 9:00 AM - 1:00 PM, Office hours 7:30 AM - 7:00 PM, Saturday 9:00 AM - 1:00 PM,
with general and well child areas.with general and well child areas.
Staggered schedule: 1st physician starts at 7:30, 2nd at 8:30, Staggered schedule: 1st physician starts at 7:30, 2nd at 8:30,
remainder start at 9:00 except for the on call physician who remainder start at 9:00 except for the on call physician who
starts at 10:00. Part time physicians with variable start times. starts at 10:00. Part time physicians with variable start times.
Post call physician does not work. Post call physician does not work.
Each full day has 32 appointment slots with various rules for Each full day has 32 appointment slots with various rules for
the number of slots allotted to specific types of appointmentsthe number of slots allotted to specific types of appointments
Who Is Beaufort Pediatrics?Who Is Beaufort Pediatrics?Who Is Beaufort Pediatrics?Who Is Beaufort Pediatrics?
Single specialty group practice with 4 full time physicians, 1 full Single specialty group practice with 4 full time physicians, 1 full
time nurse practitioner, 2 half time physicians, and Francistime nurse practitioner, 2 half time physicians, and Francis
Office hours 7:30 AM - 7:00 PM, Saturday 9:00 AM - 1:00 PM, Office hours 7:30 AM - 7:00 PM, Saturday 9:00 AM - 1:00 PM,
with general and well child areas.with general and well child areas.
Staggered schedule: 1st physician starts at 7:30, 2nd at 8:30, Staggered schedule: 1st physician starts at 7:30, 2nd at 8:30,
remainder start at 9:00 except for the on call physician who remainder start at 9:00 except for the on call physician who
starts at 10:00. Part time physicians with variable start times. starts at 10:00. Part time physicians with variable start times.
Post call physician does not work. Post call physician does not work.
Each full day has 32 appointment slots with various rules for Each full day has 32 appointment slots with various rules for
the number of slots allotted to specific types of appointmentsthe number of slots allotted to specific types of appointments
Access - How do we measure it?Access - How do we measure it?Access - How do we measure it?Access - How do we measure it?
1) Track the number of available appointments at the beginning 1) Track the number of available appointments at the beginning
of each day and every 2 hours thereafterof each day and every 2 hours thereafter
2) Note the number of practitioners available each day2) Note the number of practitioners available each day
3) Note if the providers were asked to extend, when they were 3) Note if the providers were asked to extend, when they were
asked to extend and how many extra appointments were asked to extend and how many extra appointments were
added.added.
4) Track these numbers for two weeks and then analyze the 4) Track these numbers for two weeks and then analyze the
data.data.
DataDataDataData
DataDataDataData
Available appointments at the start of the day ranged from 10-Available appointments at the start of the day ranged from 10-
44 with a mean of 2944 with a mean of 29
50% of the days the practitioners were asked to extend their 50% of the days the practitioners were asked to extend their
schedule with the receptionists needing appointments by 9:30 schedule with the receptionists needing appointments by 9:30
AMAM
Tuesdays and Fridays seem to be the most likely days needing Tuesdays and Fridays seem to be the most likely days needing
appointmentsappointments
Implement ChangeImplement ChangeImplement ChangeImplement Change
50% extension rate is too much50% extension rate is too much
Plan: We will implement blocked same day appointments. Each Plan: We will implement blocked same day appointments. Each
practitioner will have 2 appts. blocked in each half day of their practitioner will have 2 appts. blocked in each half day of their
schedule unless they are in the well child clinicschedule unless they are in the well child clinic
This should guarantee 16-24 appointments at the beginning of This should guarantee 16-24 appointments at the beginning of
each dayeach day
DataDataDataData
DataDataDataData
Available appointments ranged from 16-54 at the start of the Available appointments ranged from 16-54 at the start of the
day with a mean of 32 (10% increase)day with a mean of 32 (10% increase)
30% of the days the practitioners were asked to extend with the 30% of the days the practitioners were asked to extend with the
receptionists needing appointments by 11:30receptionists needing appointments by 11:30
Monday and Tuesday are the more difficult daysMonday and Tuesday are the more difficult days
Implement ChangeImplement ChangeImplement ChangeImplement Change
40% reduction in extended days - we’re pretty happy40% reduction in extended days - we’re pretty happy
We will continue with the present number of blocked We will continue with the present number of blocked
appointments anticipating we will need to increase the number appointments anticipating we will need to increase the number
as the level of illness increases with the onset of cold and flu as the level of illness increases with the onset of cold and flu
seasonseason
DataDataDataData
DataDataDataData
Available appointments ranged from 6-116 at the start of the Available appointments ranged from 6-116 at the start of the
day with a mean of 38 (15% increase)day with a mean of 38 (15% increase)
30% of the days the practitioners were asked to extend with the 30% of the days the practitioners were asked to extend with the
receptionists needing appointments by 11:30receptionists needing appointments by 11:30
Tuesday and Friday prove to be needy days againTuesday and Friday prove to be needy days again
Implement ChangeImplement ChangeImplement ChangeImplement Change
Still feeling pretty good, the numbers are staying about the Still feeling pretty good, the numbers are staying about the
same if not a little bettersame if not a little better
We will continue with the present number of blocked We will continue with the present number of blocked
appointments as we have yet to see a significant increase in appointments as we have yet to see a significant increase in
illness in the community.illness in the community.
DataDataDataData
DataDataDataData
Available appointments ranged from 7-78 at the start of the day Available appointments ranged from 7-78 at the start of the day
with a mean of 25 (32% decrease!)with a mean of 25 (32% decrease!)
90% of the days the practitioners were asked to extend with the 90% of the days the practitioners were asked to extend with the
receptionists needing appointments by 8:30 - 10:00receptionists needing appointments by 8:30 - 10:00
It didn’t matter what day this period!It didn’t matter what day this period!
QuickTime™ and aH.264 decompressor
are needed to see this picture.
Implement ChangeImplement ChangeImplement ChangeImplement Change
We did not anticipate well for Dr. KM’s maternity leave and were We did not anticipate well for Dr. KM’s maternity leave and were
very understaffed. However, by the end of the period were very understaffed. However, by the end of the period were
were recovering.were recovering.
We decided to leave the number of blocked appointments the We decided to leave the number of blocked appointments the
same as we were anticipating more Francis sightings over the same as we were anticipating more Francis sightings over the
upcoming weeks, and Dr. BM will be back from his time off with upcoming weeks, and Dr. BM will be back from his time off with
the baby.the baby.
DataDataDataData
DataDataDataData
Available appointments ranged from 11-45 at the start of the Available appointments ranged from 11-45 at the start of the
day with a mean of 23 (4% decrease)day with a mean of 23 (4% decrease)
18% of the days the practitioners were asked to extend with the 18% of the days the practitioners were asked to extend with the
receptionists needing appointments by 11:30receptionists needing appointments by 11:30
Tuesday once again is a consistent day needing appointmentsTuesday once again is a consistent day needing appointments
Implement ChangeImplement ChangeImplement ChangeImplement Change
Despite being understaffed, the numbers look better. The week Despite being understaffed, the numbers look better. The week
of Thanksgiving was omitted due to the altered schedule during of Thanksgiving was omitted due to the altered schedule during
that week.that week.
We were beginning to see an increase in respiratory illness We were beginning to see an increase in respiratory illness
around the community and we are understaffed, so we decided around the community and we are understaffed, so we decided
to increase the number of blocked appointments to 5 per to increase the number of blocked appointments to 5 per
provider for the next cycle.provider for the next cycle.
DataDataDataData
DataDataDataData
Available appointments ranged from 19-71 at the start of the Available appointments ranged from 19-71 at the start of the
day with a mean of 44 (91% increase!)day with a mean of 44 (91% increase!)
0% of the days the practitioners were asked to extend0% of the days the practitioners were asked to extend
Implement ChangeImplement ChangeImplement ChangeImplement Change
We overshot this cycle with the increased number of blocks and We overshot this cycle with the increased number of blocks and
an increased number of Francis sightings around the office.an increased number of Francis sightings around the office.
Despite this, given the time of year, we did not reduce the Despite this, given the time of year, we did not reduce the
number of blocks in anticipation of cold and flu outbreaks. number of blocks in anticipation of cold and flu outbreaks.
DataDataDataData
DataDataDataData
Available appointments ranged from 9-64 at the start of the day Available appointments ranged from 9-64 at the start of the day
with a mean of 30 (31% decrease)with a mean of 30 (31% decrease)
56% of the days the practitioners were asked to extend by 56% of the days the practitioners were asked to extend by
anywhere from 9:30 - 12:00.anywhere from 9:30 - 12:00.
Tues. and Wed. were the needy days.Tues. and Wed. were the needy days.
Implement ChangeImplement ChangeImplement ChangeImplement Change
We made the right choice of keeping the 5 blocks in place. We made the right choice of keeping the 5 blocks in place.
Despite this, we still needed to extend over half the days.Despite this, we still needed to extend over half the days.
Bronchiolitis is on the rise as well as gastroenteritis. No flu yet Bronchiolitis is on the rise as well as gastroenteritis. No flu yet
but should be soon. We will increase to 6 blocked appointments but should be soon. We will increase to 6 blocked appointments
per provider. per provider.
DataDataDataData
DataDataDataData
Available appointments ranged from 16-52 at the start of the Available appointments ranged from 16-52 at the start of the
day with a mean of 29 (3% decrease)day with a mean of 29 (3% decrease)
22% of the days the practitioners were asked to extend by 22% of the days the practitioners were asked to extend by
anywhere from 10:30 - 12:00anywhere from 10:30 - 12:00
Tuesday remains the most consistent day we need Tuesday remains the most consistent day we need
appointments.appointments.
Implement ChangeImplement ChangeImplement ChangeImplement Change
The increase in blocked appointments was successful again. We The increase in blocked appointments was successful again. We
had fewer extended days despite the mean staying the same.had fewer extended days despite the mean staying the same.
No planned change for the next cycle No planned change for the next cycle
What did we learn?What did we learn?What did we learn?What did we learn?
We were able to positively impact our ability to accommodate We were able to positively impact our ability to accommodate
access for our patients through a stepwise increase in the access for our patients through a stepwise increase in the
number of dedicated same day appointments based on the number of dedicated same day appointments based on the
level of illness in the community. level of illness in the community.
We were able to reduce the number of days our providers We were able to reduce the number of days our providers
needed to extend their schedules to meet appointment needs. needed to extend their schedules to meet appointment needs.
Although appointment demand is difficult to predict.Although appointment demand is difficult to predict.
Patients had more opportunity to see “their doctor” for same Patients had more opportunity to see “their doctor” for same
day appointments. day appointments.
What did we learn?What did we learn?What did we learn?What did we learn?
Tuesday is our most consistently demanding day for Tuesday is our most consistently demanding day for
appointments. Is it easier for parents to miss work on Tuesday appointments. Is it easier for parents to miss work on Tuesday
than it is on Monday?than it is on Monday?
If we have less than 5 providers on a particular day, we likely If we have less than 5 providers on a particular day, we likely
won’t have enough appointments.won’t have enough appointments.
Hopefully, this work will allow us to meet the standards for this Hopefully, this work will allow us to meet the standards for this
section of the NCAQH section of the NCAQH