The civilian health care industry has demonstrated that Access to Care can be managed effectively by creating analyst positions and placing responsibility on a dedicated staff who supports the regional organization in achieving access standards. Some MTFs, such as the National Naval Medical Center and Walter Reed Army Medical Center have taken the initiative to establish a centralized entity that supports the MTF commander in the management and monitoring of factors that make the difference in achieving access standards. MTF commanders can assure themselves that they have good access management by assessing how well it is accomplished and coordinated in their organization. Successful access management in an MTF requires that the staff responsible for the coordination of patient access accomplish the following:
- Determine the monthly patient demand for appointments and specialty base using a population supported, appointment demand model that considers such variables as past demand history for appointments, seasonal and specific weekday demand fluctuations, patient no-show rates for each clinic, etc.
- Review and approve provider and clinic appointment templates.
- Project monthly appointment demand with staff availability and coordinate with Department Chiefs. If necessary, the MTF commander or designated representative will resolve and manage the delta before a crisis occurs. The MCSC is part of the solution, but the command has to consider other alternatives as well to keep access standards on track.
- Make access and appointment utilization reports available to the command staff and Department Chiefs. TMA has made the Template Analysis Tool available to all MTFs. This analytic tool provides a real time look at the availability of clinic appointments to MTF commanders and staff. This tool is a great step that moves us closer to identifying scheduling problems by appointment type in any clinic. It provides the command the opportunity to identify and correct problems before they occur. See section as stated on this web site.
- Ensure that schedules are released for booking on at least a 30-day revolving basis for all clinics.
- Identify the benchmarks to look for in tracking schedules that are released. Also, and more importantly, coordinate predetermined intervention measures, which are agreed upon by the command to ensure access standards are met and to stay on track.
- Consider requesting a report of corrective action to be initiated and submitted to MTF commanders from any clinic that fails to meet access standards for the prior month. These concerns and their resolutions should be discussed and documented at the appropriate monthly committee meeting. Utilization Management/Review and Ambulatory Patient Care are examples of such committees where the issues and solutions to Access to Care can be discussed and documented.
Schedule Management Service (SMS) at WRAMC
SUBJECT: Schedule Management Service Support to Clinics
1. Issue: The Walter Reed Patient Appointing System has established a Schedule Management Service for assistance to the medical center staff. The Schedule Management Service (SMS), consists of four employees, an Appointment Officer, two Schedule Management Coordinators and a Data Manager. The Schedule Management Coordinators are responsible for assisting specific departments and the Data Manager works internally to the Patient Appointing System. The SMS is intended to assist with the following tasks:
- Assist Service Chiefs with developing and monitoring schedules.
- Assist Scheduling Supervisors with presenting and managing schedules.
- Develop performance standards for appointing and train staff members to standard.
- Produce data on provider schedules, including volume, mix, and utilization.
- Maintain CHCS files and tables that support appointing.
- Produce instructions to centralized clerks , including a new On-Line Guide to
Appointing, which is intended to translate "concepts to keystrokes."
- Troubleshoot and improve the appointing process.
2. Any questions regarding functions of the SMS can be directed to Mr. Troy Shelton at (202) 782-4305 DSN 662 or e-mail address is William.Shelton@amedd.army.mil.