Like many of you, our requests for same day appointments are currently at an all time high. We have 5 Adult Medicine PCPs in clinic M-F, each provider has 3 same day slots available totaling 15 per day - in theory. Except for hospital and ER discharge follow up appointments, providers are not able to pre-schedule into these slots.
We are a tribal clinic approximately 25 minutes from the nearest urgent care and ER. We are a medical home in that we also have pediatricians, our own lab, pharmacy, X-ray, PT, dieticians, and behavioral health services; but we do not offer urgent care in the truest sense. Many patients, though, view our clinic as urgent care rather than primary care. We do our best to meet their needs.
Patients begin calling the clinic at 0730 for same day appointments. Often we start our day with less than 8 open same day slots. Call center staff route all telephone encounters (TE) to the (Epic) Nurse Pool for triage and call back. One of our biggest barriers is patients not responding to our calls; many don't have voice mail and/or they don't answer their phones. Per SOP, attempts are all documented in the TE, alternative numbers are used as applicable. We don't track or record calls.
Once our same day slots are filled and providers are unable to overschedule, our provider of the day gives the go ahead to refer all requests to urgent care and/or ER. Then it becomes a matter of trying to reach patients with this news so they are not left wondering.
My questions for this group (finally!) - how many times do you attempt patient outreach for same day appointment requests? What do your attempts look like? If patients don't respond back the day of the request when do you close the TE?
Thank you for considering my questions. I did scan previous threads for answers, while I didn't find what I was looking for I did learn the magnitude of the issues surrounding same day appointments!
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Heather Zak MS, RN, ACNS-BC, CCM
Clinical Nurse Manager
Lummi Nation Health Center
Bellingham WA
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