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Changes resulting from increasing appointment length: practical and theoretical issues.

J L Campbell1, J G Howie

  • 1Department of General Practice, University of Edinburgh.

The British Journal of General Practice : the Journal of the Royal College of General Practitioners
|July 1, 1992
PubMed
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Increasing appointment length in urban teaching practices improved patient consultation and reduced waiting times. However, this change reduced system flexibility, requiring more unscheduled patient slots to manage demand effectively.

Area of Science:

  • Health Services Research
  • Primary Care Medicine
  • Healthcare Management

Background:

  • Urban teaching practices often face challenges in optimizing appointment scheduling.
  • Balancing patient consultation time with system efficiency is crucial for effective healthcare delivery.

Purpose of the Study:

  • To evaluate the impact of increasing appointment length on patient experience and operational efficiency in an urban teaching practice.
  • To assess changes in consultation duration, patient waiting times, and overall practice workload.

Main Methods:

  • A change in appointment length from 7.5 to 10.0 minutes was implemented for routine surgeries.
  • Patient waiting times and consultation durations were observed and compared before and after the change.
  • Data on workload and system flexibility were analyzed.

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Main Results:

  • Mean consultation time increased slightly (8.6 to 9.1 minutes), and mean waiting time decreased (19.1 to 14.6 minutes).
  • Overall workload remained unchanged, but system flexibility decreased, necessitating more unscheduled patient slots.
  • Teaching and trainee surgeries with fixed 10.0-minute intervals showed no significant changes.

Conclusions:

  • Extending appointment length can benefit patients by increasing consultation time and reducing wait times.
  • Achieving an optimal 'fit' between appointment supply and demand requires careful planning, including built-in flexibility (approx. 120% provision) and sufficient daily vacant slots.
  • While changes were well-received by staff, the loss of flexibility requires strategic management.