Patient arrival times for appointments [QSI Ref: XR-304]

Early or late arrival of patients can disrupt the operation of the appointment system.

Early or late arrival of patients in the department for their appointments can disrupt the operation of the appointment system, the use of radiography rooms and can cause congestion in waiting areas. This audit can help to minimise this problem, by identifying the reasons for very early or very late arrival.

The standard: 

• Locally agreed standard

• Ideally all patients should be booked in at reception within the timeframe 10 minutes before, to 5 minutes after their scheduled appointment time. There are inevitably some patients, often the elderly or those coming by hospital transport, who may arrive very early or late

• A pragmatic target of 90% could be used

Target: 

90%

Indicators: 

Percentage of patients who are booked in at reception within the period 10 minutes before to 5 minutes after their appointment time.

Data items to be collected: 

• Total number of appointments

• Number of patients arriving more than ten minutes early

• Number of patients arriving more than five minutes late

• For those patients arriving more than five minutes late or more than 10 minutes early, record the reason (e.g. parking, signposting, appointment letter)

Suggested number: 

All booked appointments over a one-month period.

If patients are not arriving within 10/5 minutes of their appointment time, the problem is often within the hospital.

The following should be reviewed and improved if possible:

• Efficiency of the booking system and allocation of appointment times

• The clarity of the appointment letter and other information supplied to patients

• The ease of parking

• The ease of registering on arrival

• The Hospital or Departmental signposting

• The portering arrangements

• The adequacy of local transport services

• Much of the data can be obtained from the RIS system

• Prospective data collection will be required if reason for early / late arrival not recorded routinely on RIS system

• Reception clerk to collect information

• Time to collate the results

1. The Audit Commission. Improving your Image. How to Manage Radiology Services More Effectively. London: Audit Commission, 1995.

2. Department of Health The NHS Constitution 2015 https://www.gov.uk/government/publications/the-nhs-constitution-for-england/the-nhs-constitution-for-england

3. NHS Choices: Your hospital outpatient appointment http://www.nhs.uk/nhsengland/aboutnhsservices/nhshospitals/pages/hospital-outpatient-appointment.aspx

Taken from Clinical Audit in Radiology 100+ recipes RCR 1996, updated by H Bailey