Implementation of the Acute Care Clinic Easy Scheduling System at the Brooke Army Medical Center
Ashley D Tapia1,2, Giselle Tapia1,2, Bradley L Snyder3
159th Medical Wing, JBSA Lackland, TX 78236, USA.
Insights
Emergency departments struggle with overcrowding. A new system allows patients to book primary care appointments while waiting, potentially reducing ED visits and improving access to care.
Area of Science:
- Healthcare Management
- Patient Flow Optimization
- Health Informatics
Background:
- Emergency departments (EDs) face persistent overcrowding, exacerbated by events like the COVID-19 pandemic.
- A significant portion of ED visits, nearly half in a prior study, could be managed in primary care settings.
- Overcrowding leads to patient care delays and increased stress on healthcare staff and resources.
Purpose of the Study:
- To pilot an alternate appointment scheduling system, the Acute Care Clinic Easy Scheduling System (ACCESS).
- To allow patients in the ED waiting room to view and book available primary care appointments.
- To assess the potential of ACCESS to alleviate ED crowding and improve healthcare access.
Main Methods:
- Developed a system displaying real-time primary care appointment availability via Tableau.
- Integrated the system with the Composite Health Care System across the San Antonio Military Health Care System.
- Provided patients with signage for web-based or call-in scheduling for appointments within 48 hours.
Main Results:
- This section is not applicable to this article.
Conclusions:
- Expansion of ACCESS could reduce ED crowding and unfilled primary care appointments.
- The system improves access to care by allowing patients to select appointments in real-time.
- The Brooke Army Medical Center ED system serves as a scalable template for other military treatment facilities.
Introduction:
Emergency departments (EDs) have continued to struggle with overcrowding, causing delays in patient care and increasing stress on the medical staff and resources. This was further illustrated during the recent coronavirus disease 2019 pandemic, where we saw large unpredictable surges to the ED as hospitals tried to meet the medical needs of patients while trying to minimize the spread of coronavirus disease. A previous study from the Department of Emergency at the Brooke Army Medical Center (BAMC) found that nearly half of the patients presenting to the ED could have been managed in a primary care setting. We sought to pilot an alternate appointment scheduling system, Acute Care Clinic Easy Scheduling System, to allow patients to see and book available appointments while waiting in the ED waiting room.
Materials And Methods:
Our appointment display system was created through collaboration with the BAMC Information Management Division. A Tableau data interface connects to the Composite Health Care System to view available primary appointments across the San Antonio Military Health Care System. These are displayed in real-time on multiple TV screens outside the ED and in the ED waiting room. Patients were provided signage that provides a way to call or use a World Wide Web-based interface to immediately schedule the open appointments within the next 48 hours. Patients voluntarily opted to use this system and may opt to leave the ED if another appointment became available within an acceptable time frame to them.
Results:
This section is not applicable to this article.
Conclusions:
Expansion of the Acute Care Clinic Easy Scheduling System within the Military Health Care System may (1) help reduce ED crowding, (2) improve access to care through a live-tracking system that patients can review and select from, and (3) reduce the number of unfilled primary care appointments. The system in place in the BAMC ED serves as a template for other MTFs to use.