A Quality Improvement Intervention to Increase

OBJECTIVE: To improve access to new pediatric endocrinology appointments in an urban academic hospital faculty-based practice. METHODS: Three strategies were implemented to increase the number of appointment slots: new patient appointments were protected from conversion to follow-up appointments; all physicians, including senior faculty, were scheduled to see 3 to 4 new patients per session; and sessions devoted exclusively to follow-up appointments were added based on demand. The main outcomes for this quality improvement activity were waiting times for new and follow-up appointments, monthly visit volume, the per-provider visit volume, differences in the proportion of new visits, and clinic arrival rates preand postintervention. RESULTS: Thirteen months after the intervention, average wait for a new patient appointment decreased from 11.4 to 1.7 weeks (P , .001) and follow-up appointment wait time decreased from 8.2 to 2.9 weeks (P, .001). Mean monthly total visit volume increased from 284 to 366 patient visits (P , .01) and mean monthly visit volume per provider increased from 36.8 to 41.0 patients (P = .08). New patients were 27% of the visit volume and 35% after the intervention. CONCLUSIONS: Access to our pediatric specialty care clinic was improved without increasing the number of providers by improved scheduling. Pediatrics 2013;131:e585–e590 AUTHORS: Rubina A. Heptulla, MD,a Steven J. Choi, MD,bc and Peter F. Belamarich, MDcd aPediatric Endocrinology and Diabetes, bDivision of Pediatric Cardiology, and dDivision of General Pediatrics, Albert Einstein College of Medicine, Bronx, New York; and cDepartment of Pediatrics, The Children’s Hospital at Montefiore, Bronx, New York