Finding better patient care, shorter wait times and more efficient practices

The Challenge: Conventional process leads to unintended consequences

Most physicians require patients to book appointments far in advance. Yet patients who need urgent care want to see their physicians right away. And if they can’t get appointments immediately, they often search for care elsewhere—usually in hospital emergency rooms. This process creates a trickle-down effect of backlogs and delays at hospitals and throughout care systems.

The Improvement Project: Analyzing advanced access for Cape Breton

Elaine Rankin, Director of Primary Care and Population Health at the Cape Breton District Health Authority, took steps to address this challenge by examining through her EXTRA intervention project the concept of advanced access and its feasibility for practices in Cape Breton. Advanced access is a scheduling process that leaves physicians’ appointment calendars open and makes same-day appointments available to patients based on need.

The Result: Pilot project tests benefits of advanced access

Rankin’s research convinced her that physicians in Cape Breton could readily implement this approach. In collaboration with a number of physicians, Rankin launched a pilot project to implement advanced access and gauge its effectiveness.

The Impact: More physicians adopting this superior approach to scheduling

Results of the pilot project were immediate and impressive. Participating physicians reported a marked reduction in patient no-shows, a noticeable increase in their efficiency during patient visits and improved use of overall staff resources. Benefits went beyond physicians’ offices. ER visits for non-urgent complaints made by patients of participating physicians dropped 28 percent. As a result of these outcomes, increasing numbers of Cape Breton physicians are making the transfer to advanced access, and the provincial health department now advocates spreading advanced access as a priority task in its primary care action plan.

Elaine Rankin image

Elaine Rankin
Director of Primary Care and Population Health
Cape Breton District Health Authority
Sydney, Nova Scotia

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