"The rheumatologist can see you now": Successful implementation of an advanced access model in a rheumatology practice

Arthritis Rheum. 2004 Apr 15;51(2):253-7. doi: 10.1002/art.20239.


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.

MeSH terms

  • Academic Medical Centers / economics
  • Academic Medical Centers / organization & administration
  • Appointments and Schedules
  • Health Services Accessibility / economics
  • Health Services Accessibility / organization & administration*
  • Humans
  • Models, Organizational
  • Patient Satisfaction
  • Program Evaluation
  • Referral and Consultation
  • Rheumatic Diseases / therapy*
  • Rheumatology / economics
  • Rheumatology / organization & administration*