The impetus for more efficient scheduling in community mental health stems from the fact that in nearly all contexts, there are limits on the resources available to deliver services. The failure of patients to attend scheduled psychiatric appointments compounds this problem. Psychiatric no-shows occur with a reported frequency as high as 60% (Smoller, McLean, Otto and Pollack, 1998). No-shows result in inefficiency and decreased productivity for the clinic, and are also a detriment to the patient. Missing psychiatric appointments has been associated with disruption of treatment, exacerbation of symptoms, functional impairment, and increased risk for psychiatric hospitalization (Molfenter, 2013) Missed appointments in child and adolescent
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In contrast to the traditional scheduling model in which psychiatric appointments are booked weeks or months in advance, open access appointment scheduling, also known as advanced access or same-day scheduling, is a scheduling method in which patients are offered an appointment on the day that they call or at the time of their choosing, preferably within 24 hours. In theory this results in minimal wait time for appointments, increased scheduling flexibility, and decreased no-shows (Murray M and Tantau C, 2000). In essence, the open access model applies the principle of queuing in an effort to match the demand for appointments with the time of the clinician. Demand and capacity must be properly balanced, however, for open access scheduling to be successful. Given that patient demand is highly difficult to predict, open access scheduling has the potential to fail if not somehow customized to accommodate the inevitable unpredictability of client calls for appointments (Lee S and Yih Y, …show more content…
Although OCMOAS 's ability to control the demand stream might be attributed to the high rate of scheduling with the primary provider, an alternative explanation might suggest that this particular provider 's caseload was already ideally suited in volume to accommodate a high rate of continuity. A larger study with multiple providers would provide greater clarity on this question. Other limitations include potential error in electronic medical record reporting, the unmeasured impact on the no-show rate of requiring a face to face meeting before medications would be refilled, the tracking of only med check appointments as opposed to psychiatric evolutions and therapy sessions, and the use of text messaging versus telephone calls for appointment
In contrast to the traditional scheduling model in which psychiatric appointments are booked weeks or months in advance, open access appointment scheduling, also known as advanced access or same-day scheduling, is a scheduling method in which patients are offered an appointment on the day that they call or at the time of their choosing, preferably within 24 hours. In theory this results in minimal wait time for appointments, increased scheduling flexibility, and decreased no-shows (Murray M and Tantau C, 2000). In essence, the open access model applies the principle of queuing in an effort to match the demand for appointments with the time of the clinician. Demand and capacity must be properly balanced, however, for open access scheduling to be successful. Given that patient demand is highly difficult to predict, open access scheduling has the potential to fail if not somehow customized to accommodate the inevitable unpredictability of client calls for appointments (Lee S and Yih Y, …show more content…
Although OCMOAS 's ability to control the demand stream might be attributed to the high rate of scheduling with the primary provider, an alternative explanation might suggest that this particular provider 's caseload was already ideally suited in volume to accommodate a high rate of continuity. A larger study with multiple providers would provide greater clarity on this question. Other limitations include potential error in electronic medical record reporting, the unmeasured impact on the no-show rate of requiring a face to face meeting before medications would be refilled, the tracking of only med check appointments as opposed to psychiatric evolutions and therapy sessions, and the use of text messaging versus telephone calls for appointment