Same/next day appointments or Reasonable wait for appointment – Interpretive notes

Updated as of January 22, 2016

Recall Bias:

There is a chance that patients may not recall how long they waited for an appointment the last time they visited their provider.
- There could be bias in either direction, with the patient wanting to be positive (i.e. under-estimating the time) or the patient being generally unsatisfied and therefore over-estimating the time.
There is likely inconsistency in the recall of patients regarding whether the person they saw was their “own” provider or someone else on the team.

The level of access to care in your team might be lower than indicated by D2D because it only considers the access of patients who eventually had an appointment.
Patients who didn’t get an appointment soon enough (or when they wanted it) might never have shown up and instead may have either gone nowhere or to a walk-in clinic, an Emergency Department or another team. Therefore, these patients would never have been included in the survey.

Performance on this measure does not necessarily reflect patient choice because some patients would PREFER to have an appointment set several days in advance, instead of on the same or next day, as it makes it easier for them to plan.
The measure might also be counter-intuitive to the known desire of patients to see their “own” regular provider. Efforts to increase the proportion of patients getting appointments within the same/next day might be counter-productive to efforts aimed at helping patients see their “own” regular provider as much as possible.

In spite of best efforts, there is likely inconsistency in the wording of the question between teams.

The measure as it is currently defined does not distinguish between appointments for an urgent issue vs. appointments for more elective concerns such as well-baby check-ups, follow-ups and preventive visits.
The measure is counter-intuitive to the purpose of interprofessional team-based care when the wording specifies access to an appointment with the patient’s“own” regular provider. Team-based care suggests that anyone in the team could and should be able to help the patient, whenever they need it.