Improving Administrative Outcomes in Physiotherapy by Adopting Open-Access Booking

Long wait times for physiotherapy are associated with poorer health trajectories for clients. Clients' experiences with physiotherapy services in Saint John were suboptimal; thus, this study explored making administrative changes to improve those experiences. All physiotherapy services adopted an administrative model called open-access booking (OAB), which blended elements of advanced access, triage, and centralized wait lists. OAB was instituted in the first week of February 2017 and has been active since. The researcher accessed more than 20,000 anonymized case records spanning 5 years (February 2014-January 2019) and compared the 3-year pre-OAB phase with the 2-year OAB phase using interrupted time series analysis models. OAB appeared to not be associated with changes in client volume, but it was associated with fewer "on-paper" clients, shorter wait times to first appointment, more consistent record keeping, a greater likelihood of being discharged after one appointment, and fewer appointments before discharge. There was less variability in these outcomes after the adoption of OAB, suggesting a more stable client experience with the physiotherapy system. OAB appears to be associated with improved administrative outcomes, but strict causality cannot be assessed. The results are promising but not conclusive.