Gaps in practice

January/February 2011

FocusGaps in practice


Getting it right

Volume 40, No.1, January/February 2011 Pages 20-23

Andrew Knight

Tony Lembke


Only 36% of sick Australians report being able to get an appointment on the day they need it, which is poor by international standards. This delay in care may impact on practice team morale, practice profitability and patient care. The Australian Primary Care Collaboratives Program aims to find better ways to provide primary healthcare services to patients through shared learning, peer support, training, education and support systems.


This article shares lessons from the Australian Primary Care Collaboratives Program that can help practices improve appointment scheduling. We describe steps to improving control of your practice scheduling – and your life – by measuring your practice demand, capacity and delay.


Demand for appointments is finite, predictable and can be shaped. Delay is waste and the enemy of good healthcare. Where delay can be eliminated it should be. By measuring practice demand and capacity, improvements can be designed which will result in reduction in measured delay and patient unmet needs, and increased patient satisfaction.

Imagine a perfectly organised day in your general practice. You arrive to see a third of your appointments still available. They fill as people ring during the day. Receptionists are able to say ‘yes’. Patients don’t book long in advance because experience tells them they will get an appointment today if they need it. There are no forgetful ‘did not attends’. Your day is an interesting mix of problems – some chronic (booked in advance) and some acute (rang today). Patients can plan around transport and work. You run on time because no-one is squeezed in. You have time to eat and debrief. Your message book is almost empty because everyone had their urgent needs met at their appointment. You are ‘down the drive by half past five’: patients happy, results checked and inbox emptied.

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