title: Productivity measures associated with a patient access initiative.
abstract: OBJECTIVE
  To assess financial performance associated with a patient 7-day access initiative.
  
  
  BACKGROUND
  Patient access to clinical services is frequently an obstacle at academic medical centers. Conflicting surgeon priorities among academic, clinical, educational, and leadership duties often create difficulties for patient entry into the "system."
  
  
  METHODS
  The scope and objectives were identified to be: design of a standard, simple new patient appointment process, design of a standard process in cases where an appointment is not available in 7 days, use subspecialty team search capabilities, minimize/eliminate prescheduling requirements, centralize appointment scheduling, and creation and reporting of 7-day access metrics. Following maturation of the process, the 7-day access metrics from the period July 2004 to December 2004 and January 2005 to June 2005 were compared with corresponding time periods from calendar years 2001, 2002, and 2003.
  
  
  RESULTS
  Payor mix was unaltered. The median waiting time for a new patient appointment decreased from 21 days to 10 days. When compared with calendar years 2001, 2002, and 2003, respectively, the 2 periods of the 7-day access initiative in calendar years 2004 and 2005 were associated with significantly increased visits, new patients, operative procedures, hospital charges, and physician charges.
  
  
  CONCLUSIONS
  Implementation of a 7-day access initiative can significantly increase financial productivity of general surgery groups in academic medical centers. We conclude that simplifying access to services can benefit academic surgical practices. Sustaining this level of productivity will continue to prove challenging.
authors.affiliation: Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA.
authors.forename: William H
authors.initials: WH
authors.lastname: Gable
authors.forename: Theodore N
authors.initials: TN
authors.lastname: Pappas
authors.forename: Danny O
authors.initials: DO
authors.lastname: Jacobs
authors.forename: Desmond A
authors.initials: DA
authors.lastname: Cutler
authors.forename: Paul C
authors.initials: PC
authors.lastname: Kuo
mesh_terms: D000465:Algorithms; D001071:Appointments and Schedules; D006297:Health Services Accessibility / Q000458:organization & administration* / Q000706:statistics & numerical data*; D006801:Humans; D013503:Surgery Department, Hospital / Q000458:organization & administration*; D013514:Surgical Procedures, Operative; D014481:United States