Imagine walking into a clinic and being told you can see a physician the same day. For most patients, this scenario feels as unlikely as winning the lottery. Yet, Allen M. Chen, MD and his colleagues at a tertiary-based National Cancer Institute-affiliated center have demonstrated through a two-year pilot initiative that same-day appointments are not only feasible but transformative. Their work, recently published in The Journal of Healthcare Management, highlights a new concept for patient care that prioritizes immediate access.
As healthcare leaders, we know that long wait times undermine patient satisfaction, lead to missed appointments, and delay care, which can directly harm outcomes and quality scores. With thoughtful preparation and strategic leadership, same-day visits offer a tangible solution to improve operational efficiency, enhance patient experience, reduce costs, and actually support clinician well-being (the elusive and sought-after Quadruple Aim). I recently wrote about improving access to care; creating same-day visits is another move in the right direction.
The case for same-day visits
Dr. Chen’s pilot program focused on offering same-day appointments to newly diagnosed cancer patients. Of the 4,301 patients scheduled over two years, 14% opted for same-day access. The results were staggering; patients seen within five days increased from 61% to 99%, while no-show rates plummeted from 8% to 1%. These statistics underscore the potential of same-day access to improve both clinical outcomes and operational benchmarks.
From an outcome perspective, the stakes couldn’t be higher. A meta-analysis cited in the study showed that delays of just one month in cancer treatment can increase mortality by 6-13%. The operational benefits are equally compelling. No-shows and appointment backlogs drain resources and frustrate staff, while streamlined scheduling enhances efficiency and revenue.
Implementing same-day visits
Optimizing existing scheduling capacity is one of the most critical steps in implementing same-day visits. Dr. Chen’s team began by auditing physician schedules and identifying inefficiencies. Many follow-up visits were deemed unnecessary; for instance, patients treated for low-risk prostate cancer were returning every three months for more than a decade, often seeing different physicians. By creating survivorship care templates to transition these patients to primary care, significant capacity was freed up. Another critical insight was the identification of “choke points” in scheduling. Time studies revealed that excessive blocks of time were reserved for non-patient activities, such as documentation and patient conferences. The clinic could accommodate more patients without adding workload by reallocating this time.
Streamlining the appointment process was another key strategy. Centralized intake coordination proved invaluable, with the researchers meeting daily to review consults and strategically fit same-day add-ons. Standardizing the approach, including consistent language when offering same-day options (“Would you like to see a specialist today?”), reduced variability and patient confusion. Personalized communication also played a significant role. Unlike practices that rely on automated phone systems, Dr. Chen’s team emphasized voice-to-voice interactions, making patients feel prioritized and valued.
The program leveraged existing resources rather than overhauling schedules or creating additional slots. Same-day visits were integrated into existing physician workflows, minimizing resistance from doctors wary of increased workload. Telehealth added further flexibility, allowing physicians to accommodate patients remotely when in-person visits weren’t feasible. Looking ahead, artificial intelligence (AI) tools could further refine scheduling by predicting peak demand and identifying high-risk patients who may need longer appointments or are prone to cancellations.
Building contingency systems was essential to ensure the sustainability of same-day visits. A tiered prioritization system allowed schedulers to move from one clinician to another if no openings were available, ensuring patients’ needs were consistently met. Ancillary staff, such as nurses and administrative support, also played a crucial role in managing increased patient flow. Adequate staffing in these areas prevented bottlenecks and ensured smooth operations (team-based care for the win!)
Gaining stakeholder buy-in
Introducing same-day visits required a cultural shift within the organization. The researchers tackled this challenge through leadership engagement and open communication. Town halls and workshops provided forums to address concerns, explain the program’s goals, and highlight its potential benefits. Sharing patient stories and early successes helped align staff with the program’s mission and build enthusiasm.
A dedicated physician champion proved instrumental in driving adoption. This leader worked closely with staff to address operational challenges, communicated the program’s value to hesitant clinicians, and served as a visible advocate for the initiative. The physician champion helped bridge the gap between leadership and frontline staff by demonstrating a hands-on approach and fostering trust.
Overcoming challenges
Implementing same-day visits was not without its challenges. Resistance to change was a common hurdle, particularly among staff accustomed to traditional workflows. To address this, Dr. Chen’s team introduced a pilot phase that allowed time for feedback and adjustment. This iterative approach helped build confidence and reduce skepticism.
Clinician burnout was another concern. To prevent overwork, safeguards were put in place, such as an 11:00 AM cutoff for same-day scheduling. Technology also played a key role in addressing logistical challenges. Electronic health records (EHRs) facilitated the retrieval of medical records and coordination of same-day bookings, ensuring efficiency without compromising patient safety.
Using data to drive success
Continuous data monitoring was integral to the program’s success. Key performance indicators, such as time-to-treatment and no-show rates, were tracked and reviewed monthly. This data-driven approach allowed for real-time adjustments and improvements. Equity was also a focus, with analyses examining whether same-day visits improved access for underserved populations.
Celebrating early wins helped sustain momentum. Positive patient testimonials and success stories were shared with staff and stakeholders, reinforcing the program’s value and silencing skeptics. This approach built a sense of pride and ownership among team members, further driving adoption.
Scaling and broader implications
Same-day visits have the potential to transform patient care across various specialties. For primary care clinics struggling with high no-show rates, this model can reduce missed appointments and improve chronic disease management. In orthopedics, same-day access could accelerate care for acute injuries, preventing complications and reducing emergency department visits. The scalability of this model offers healthcare leaders a powerful tool to address access challenges and enhance patient-centered care.
Conclusion
The implementation of same-day visits is not without its challenges, but as this study demonstrates, the rewards far outweigh the risks. By addressing operational inefficiencies, engaging stakeholders, and using data to drive improvements, healthcare leaders can transform patient access and satisfaction. The question is no longer whether same-day visits are feasible. The question is: Will you be the leader who makes it happen in your organization?