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The appointment system underpins many of the practice's
operations. Your appointment system needs to be well designed and
effectively administered. If it is, it will support patient care
and safety. It will contribute to effective time management. It
will assist you in monitoring patient attendance.
Your appointment system can be paper based but it is more common
to use a computerised system. Assistance with the choice of system
can be sought from your professional college (see links). Ensure you and your staff receive
comprehensive training so that all the system's features and
functions can be fully utilised. Computerised appointment systems
can be viewed by the practitioner throughout the day to help
monitor waiting times and patient priorities. It can also help
manage no-shows and cancellations.
Inform new patients about your appointment policy and
procedures. They need to know what your expectations are regarding
cancellation of appointments, whether they will be notified if
there are delays, and what 'reasonable access' actually means. This
information can be presented as part of the information included in
the form of a practice brochure and could include:
For obstetricians, the following points could also be considered
in the appointment scheduling:
Download the Appointment System checklist
In the development of your appointment policy and protocols, you
will also need to consider triage and delegations. A triage system
allows identification of patients who require priority access to
the practitioner/treatment due to potentially serious/urgent
A particular skill required by front desk staff is the ability
to prioritise, or triage patients - whether this is by patient
presentation at the practice or by referral from another
practitioner by phone, so that the sickest can be treated first.
Appointment systems should enable prioritising of appointments,
either labelling or colour-coding 'urgent' appointments so
practitioners can easily determine the status of patients in the
If your expectations of your staff with regards to triage do not
match their qualifications and/or training, you are endangering
your patients and leaving your staff (and hence yourself)
The ideal features of an appointment system can be classified as
supporting time management, patient satisfaction and patient
Ideally, an appointment system should include the following
features to ensure the best time management:
A patient's non-attendance or cancellation of a review
appointment may be an indication of a dissatisfied patient but also
can require clinical follow-up. When a patient does not present for
a scheduled appointment, or leaves before being seen by medical
staff, the practitioner should be notified. With existing patients,
document why the appointment has been cancelled and what further
action, if any, should or has been taken.
If you have concerns about patient compliance, a letter could be
sent to the patient or to the referring practitioner and a copy of
this letter kept on the patient's file. If the condition is
serious, the letter should be sent to the patient by registered
post (see section below on compliance).
Use the appointment system for:
To maximise quality patient outcomes it is important that the
appointment system alerts the practitioner to patient compliance
and supports the recall and monitoring requirements.
The practitioner should be made aware of all "no shows" and
cancellations so that a decision can be made if further action is
If a computerised appointment system is utilised, this will
often be linked to the practitioner's desk where non-attenders and
cancellations are retained on the daily scheduling screen.
For computerised appointment systems, you should ensure clear
protocol for staff regarding communication with practitioners about
cancellations or rescheduled appointments, as these will disappear
off the day's appointment list as they are cancelled or moved.
Your practice protocol might be for staff to add cancelled or
rescheduled appointments back onto the bottom of the day's
appointment list with a notation. This would mean practitioners
could easily review the changes and make a decision as to whether
follow-up action is required.
For paper-based appointment systems, this can be supported by