IOM outlines pathway to cut wait times, increase access to care

Hospitals can deliver key services much more quickly and achieve related quality improvements without significantly adding to costs, according to a new Institute of Medicine (IOM) report.

Shifting resources, changing cumbersome processes and rethinking how services are delivered can result in dramatic changes, according to the report by the IOM Committee on Optimizing Scheduling in Healthcare. The report was prompted by the high-profile scheduling issues at the VA's hospital in Phoenix, in which 40 veterans died while waiting for appointments, but apply across healthcare settings, according to the report summary.

Regardless of the setting, providers that successfully deliver services quickly share several best practices for basic access, the committee found. Among them:

  • Matching supply and demand through continuing evaluation
  • Immediately determining need when the patient inquires about services
  • Learning when the patient wants to come in and what kind of care is desired
  • Offering need-tailored, technology-enabled alternatives to clinic visits, when appropriate
  • Formal planning for patient surges
  • Constantly assessing changing circumstances

Some of those practices come with their own challenges. A recent survey, for example, found that two-thirds of patients queried said they would be somewhat or very unlikely to use telemedicine instead of meeting face-to-face with their provider.

As the healthcare community works to engineer solutions, one of the biggest challenges is there's no national standard for providers to use in setting guidance for or accessing success in providing timely access to care, according to an online article in the Journal of the American Medical Association.

To change that, the committee recommended that national leaders, including those from healthcare advocacy groups, collaborate to implement principles for basic access, coordinate federal implementation initiatives, and develop, test and apply standards for access to care.

Hospital leaders, meanwhile, should commit to frontline scheduling practices anchored in principles of basic access, engage patients and families in redesigning scheduling processes, and continuously assess progress and adjust practices as needed to deliver timely access.

The committee isn't the first to examine access to care. Analysts for McKinsey & Co. have recommended numerous strategies including scheduling appointments outside of normal business hours, letting patients make appointments online as well as over the phone, and standardizing scheduling templates to better coordinate care.

To learn more:
check out the report (download or read online)
here's the summary, with links to other sections
read the JAMA article