Appendix 3:
Advanced/Open Access Scheduling in Family Practice

Continuity & Comprehensiveness of Care

Appendix 3:

Advanced or open access, which facilitates same day appointments, has been introduced to primary care practices internationally as well as in Canada. While not every appointment will or should be the same day, patients presenting with acute, semi-urgent or non-urgent symptoms, may benefit from advanced access scheduling by their family physician.

Defined by American physician, Dr. Mark Murray, advanced or open access scheduling has been shown in some settings to improve access to primary care by:

  • Balancing supply and demand
  • Reducing backlogs
  • Reducing the variety of appointment types
  • Developing contingency plans for unusual circumstances
  • Working to adjust demand profiles
  • Increasing the availability of bottleneck resources

References:

Implementation

  1. Advanced Access - Resources for Clinical Practices

  2. Changing Business Practices for Appointing in Military Outpatient Medical Clinics: The Case for a True “Upon Access” Appointment Scheme for Primary Care. Meyers M. Journal of Healthcare Management 2003; 48(2): 125-39.

  3. Implementing Advanced Access in a Group Practice Network. Pierdon S, Charles T, McKinley K, Meyers L. Family Practice Management 2004; 11 (5): 35-8.

Evaluation

  1. A Qualitative Study of the Impact of the Implementation of Advanced Access in Primary Health Care on the Working Lives of General Practice Staff. Ahluwalia S, Offredy M. BMC Family Practice 2005; 639 doi: 10 11861. Accessed January 20, 2007.
  2. A Controlled Trial of an Advanced Access Appointment System in a Residency Family Centre. Beldardi F, Weir S, Craig F. Family Medicine 2004; 36 (5) 34-5.
  3. Open Access in Primary Care: Results of a North Carolina Pilot Project. Bundy D, Randolph G, Murra M, Anderson J. Pediatrics 2005; 116 (1): 82-7.
  4. Evaluation of Advanced Access in the National Primary Care Collaborative. Pickin M, O’Cathain A, Sampson F, Dixon S. British Journal of General Practice 2004; 54: 334-40.
  5. Implementation of Advanced Access in General Practice: Postal Survey of Practices. Goodall S, Montgomery A, Banks J, Salisbury S, Sampson F, Pickin M. . British Journal of General Practice 2006; 56 (33): 918-23.
  6. Improving Timely Access to Primary Care: Case Studies of the Advanced Access Model. Murray M, Bodenheimer T, Rittenhouse D, Grumback K. JAMA 2003; 289, 8: 1042-6.
  7. The Outcomes of Open-Access Scheduling.O’Hare C, Corlett J. Family Practice Management 2004; 11 (2): 35-8.