Why this measure is important:

  • By ensuring timely appointment access we aim to avoid delays which can be harmful to those seeking care. Our improvement efforts are focused on developing highly efficient scheduling systems that can meet the needs of our patients and families.  
  • 3rd Next Available is the industry standard for measuring appointment access. In contrast to first and second available appointments that are often the result of last minute cancellations, working patients into the schedule, or other events, 3rd next best represents the performance of the appointment access system as a whole. This measure shows the percent of divisions with a wait time that is 10 days or less.

How we measure:

  • We measure the new visit types that represent the highest volume for each division. This ensures that our improvement efforts are focused where there is the greatest demand for services.  
  • One data point is collected, once each week for selected visit types for each outpatient clinic. Once a week, call center staff manually uses the scheduling system and attempts to make a “fake” patient appointment for certain appointment types. For each visit type, they “spin” the scanner for the next available appointment. Once that is found, the Call Center agent “spins” 2 additional times to identify the 3rd next available appointment.


Click here to view a larger version of the chart in PDF format.

What we are doing to improve:

  • Most divisions have been able to maintain their goal of providing 3rd next available appointments within 10 days. When the number of days to provide a 3rd next appointment has a significant increase, divisions are required to develop a plan to address.
  • There are divisions whose 3rd next available appointment exceeds the 10 day target. For these divisions, specific goals have been established to decrease 3rd next available appointment by a specific amount. Dedicated improvement teams are working with these divisions to develop and implement division-specific interventions.
  • A decision tree algorithm, which is based on a supply management tool, has been implemented to improve and stabilize performance on this measure. This tool allows divisions to plot their performance within the algorithm and identify metrics for additional follow up. From this, specific change action items are pursued.

View the Operational Definition:  3rd Next Available Appointment