Patients will expect same-day scheduling

They're willing to go elsewhere

Can I get this diagnostic test done here today?" If the answer to this question is "no," the patient standing in front of you might go elsewhere for services, warns Jennifer Nichols, director of patient access at Spectrum Health in Grand Rapids, MI, where same-day scheduling is now offered to radiology patients.

"We are seeing that patients are willing to go to other locations if they can be seen sooner," says Nichols. "They will often call multiple hospital or service providers."

Patients are become increasing sophisticated consumers, and they understand that their physician's order possibly can be fulfilled at many locations, says Nichols. "In addition, provider offices prefer this option," she says. "They are eager to have the diagnostic results back in order to proceed with patient care."

Hospitals must compete with stand-alone facilities that offer patients appointments when they want them, says Wendy M. Roach, RDMS, manager of patient access and central scheduling at Advocate Good Shepherd Hospital in Barrington, IL. "Patients want appointments to meet their needs and their schedules," Roach says. Consider taking these steps before offering same-day scheduling:

• Get support from the imaging leadership team.

"This smooths the transition of adding onto an already filled schedule," says Roach. To accommodate same-day appointments, imaging departments must work around their currently scheduled outpatients, "stat" add-ons, emergency patients, and inpatients, she explains.

• Be sure staff members obtain a valid and appropriate provider order prior to the procedure.

Because patients often carry in a written order for a diagnostic test, clinical staff must be aware of the organization's requirements for a valid order, says Nichols.

"Some items are federally mandated, like prohibiting the use of certain abbreviations. Other items may vary by hospital, possibly," she says. "Staff need to ensure that they have those elements present and legible."

• Have items on hand for service recovery.

"Even with the best intentions and plans, you might have patients that will wait longer than expected," says Roach. "Having a gift certificate or gas card to give them is a necessity." Patient access staff members typically give patients a $25 gas card, she adds.

• Develop a strong partnership between patient access and clinical care teams.

At Spectrum Health, members of the radiology department and the offsite central scheduling team collaborate in making any necessary adjustments to accommodate a patient. Recently, radiology staff members agreed to convert two existing slots on the day's schedule into a single slot, so a lengthier procedure could be scheduled, for example.

"We have a clear culture of never turning a patient away, and accommodating same-day needs," says Nichols. "We also have highly responsive middle and upper leadership for escalation."

• Carefully review schedules and slots.

"Understand the types of same-day visits that the department is anticipating," says Nichols. "Build access to those types of visit slots in advance of deploying such a program." (See related stories, p. 77, on obtaining authorizations for same-day scheduling, and unique challenges for collecting with same-day services, this page, right.)


For more information on same-day scheduling, contact:

• Jennifer Nichols, Director, Patient Access, Spectrum Health, Grand Rapids, MI. Phone: (616) 308-4119. E-mail:

• Wendy M. Roach, RDMS, Manager, Patient Access and Central Scheduling, Advocate Good Shepherd Hospital, Barrington, IL. Phone: (847) 842-4186. Fax: (847) 842-5325. E-mail: