title: "The rheumatologist can see you now": Successful implementation of an advanced access model in a rheumatology practice.
abstract: OBJECTIVE
  To provide rheumatologic care to patients in a timely and patient-centered manner.
  
  
  METHODS
  We developed and implemented processes to measure and help eliminate backlog, created access time for same-day patients, and retooled the appointments process to be more efficient and patient focused. In addition, we developed a protocol to be used by our primary care colleagues to care for osteoarthritis of the knee in a standardized manner.
  
  
  RESULTS
  The third available rheumatology appointment fell from about 60 days to <2 days. Cancellations fell from 40% to <20%. Patient satisfaction measures (composite score, physician score, and accessibility score) improved significantly. The number of new patients seen for knee osteoarthritis decreased by 6.7%, whereas the number of new rheumatoid arthritis referrals increased by 50.4%. Financial performance improved as well.
  
  
  CONCLUSIONS
  This advanced access model in a busy academic rheumatology practice demonstrated considerable improvement in access, patient satisfaction, and finances. Using a team approach, we are now able to give the patient the rheumatologic care they want and need at a time they want and need it.
authors.affiliation: Geisinger Medical Center, Danville, Pennsylvania, USA. enewman@geisinger.edu
authors.forename: Eric D
authors.initials: ED
authors.lastname: Newman
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Harrington
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Olenginski
authors.forename: James L
authors.initials: JL
authors.lastname: Perruquet
authors.forename: Karen
authors.initials: K
authors.lastname: McKinley
mesh_terms: D000046:Academic Medical Centers / Q000191:economics / Q000458:organization & administration; D001071:Appointments and Schedules; D006297:Health Services Accessibility / Q000191:economics / Q000458:organization & administration*; D006801:Humans; D017146:Models, Organizational; D017060:Patient Satisfaction; D015397:Program Evaluation; D012017:Referral and Consultation; D012216:Rheumatic Diseases / Q000628:therapy*; D012219:Rheumatology / Q000191:economics / Q000458:organization & administration*