Improving Appointment Line System

NAME OF HEALTH DEPARTMENT: Pitt County Health Department

PROJECT TITLE: Improving Appointment Line System

Terri Wilson, RN
Pitt County Health Department
201 Government Circle
Greenville,  NC  27858
Fax: 252-413-1446                                                     

Project Overview

Project Aim:
We aim to reduce the client time it takes to make an appointment using the telephone appointment system.  It is important that our clients have a positive first impression of our agency.  By September 1, 2011 we will provide appointments to individuals as well as those representing individuals from other agencies the first time the call is made and in less than 10 minutes.  We will achieve this goal by using strategies we learn in the NC Public Health Quality QI 101 course as well as follow guidelines for appointments set forth in program Agreement Addendums.


  • Reduce time spent by the client to less than 10 minutes.
  • Appointment will be made in one phone call.
  • Decrease the no-show rates of clinic appointments to no more than 20%.
  • Experience no decrease in customer satisfaction.

Project timeframe:
December 2010 to Late Fall/Early Winter 2011

How was the need for the project determined?
We had received feedback from community members via client satisfaction surveys and antidotal reports of difficulties in scheduling appointments.

Does this quality improvement project link to accreditation?
This project relates to benchmark 19.1- The local health department shall assess use of public health programs and health care services by underserved, at-risk and vulnerable populations identified in the community health assessment process.

Areas for Improvement and Change Ideas Implemented

Improvement 1
Our appointment system in our Communicable Disease Clinic was divided into four appointment options; STD’s, childhood immunizations, contraceptive method supplies, and miscellaneous. The STD clinic stayed filled and the appointment line staff were alerting us that they were having to tell patients to call back for appointments because the schedule was full.  (We operate on an Open Access appointment system.)  Other clinics such as the contraceptive method clinic and the childhood immunization clinic usually had open slots.  Our first change was to combine services in relation to the amount of time it took to conduct the service; STD and childhood immunizations were  grouped as 60 minute services and the contraceptive method supplies, TB med pick ups and the STD treatment only services were grouped as 30 minute services. These changes enabled us utilize empty appointment slots for patients needing other high demand services.  The first six weeks of this change yielded an increase of 96 additional STD screens.

Improvement 2
An Express STD clinic was created to serve asymptomatic STD clients.  By serving these clients in a separate clinic, space for symptomatic STD clients could be made available in the main STD clinic.  The first two weeks of operation yielded a 93% show rate.


Overall Improvements

  • The number of STD exams increased by 96 exams the first six weeks changes were made in the STD Clinic.  There is an increase of 131 in the number of STD exams performed May through August 2010 and May through August 2011.
  • The STD Clinic A Express Clinic experienced a 93% show rate the first two weeks of opening.  There has been on overall show rate of 89% in that clinic.
  • The average number of clients told to call back improved (# decreased) by 7 patients a day.

Lessons Learned:

  • One of our lessons learned is the importance of choosing your project then choose the people.  When team members do not see a connection between their job and the project, engagement is poor. 

Programs supported by:

BlueCross BlueShield of NC FoundatoinThe Duke Endowment

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