Advanced Access Scheduling in Primary Care: A Synthesis of Evidence

Advanced access (AA) scheduling aims to improve primary care throughput by decreasing appointment scheduling wait time for patients. The primary objective of this article is to provide a review and analysis of the evidence comparing AA scheduling in primary care with traditional scheduling. A comprehensive search of electronic databases (PubMed, Cochrane, CINAHL, Web of Science, PsychINFO) from 1999 through 2018 was completed to identify all studies that compared practice and patient outcomes before implementation of AA scheduling and after implementation in primary care. PRISMA-P 2015 protocol guidelines for systematic review were used. Of the 177 studies eligible for inclusion, 18 satisfied all inclusion criteria. Findings suggest that AA scheduling may reduce appointment scheduling wait time (83%) and no-show rates (67%), increase patient volume (50%) and productivity of providers (83%), and decrease emergency and urgent care visits (75%). Patient and staff satisfaction, continuity of care, revenue, and quality of care outcomes were mixed in terms of improvement. This author investigated definition controversies, implication to stakeholders, differences in scheduling implementation, and measures and outcomes of AA in primary care. The analysis found that AA scheduling promises to improve access in primary care. Further research must be conducted to better inform healthcare stakeholders on how, where, and with whom AA scheduling systems can be best implemented.