Columbia University Medical Center

Practice Tip: Orthopedics Same-Day Scheduling

Orthopedics department administrator Barbara "Bonnie" Hewson.

Orthopedics department administrator Barbara “Bonnie” Hewson.

Same-day appointments always have been offered by the Orthopedics scheduling team. They “create stable volume, revenue, and the practice growth of our non-MD providers,” according to department administrator Barbara “Bonnie” Hewson.

The rate of same-day appointments has held steady from 2013 to 2014, increasing slightly  from 6.3 percent to 6.5 percent.

The department expects to see growth in this area as more same-day access becomes available, Hewson says.

The chart below shows the number of same-day appointments booked from December 2013 through July 2014.

Same-Day Appointment Highlights
Dec-July FY14
Total Arrived Patients
New Appointments (arrived)
Follow-up Appointments (arrived)
Average Same-Day Appointments


Most Orthopedics patients need the assistance of other departments, which requires collaboration to coordinate the requests. This collaboration has been standardized and is performed on a case-by-case basis. For example, Orthopedics will contact Radiology to arrange same-day appointments when the patient also requires imaging.

Typically, requests for same-day appointments are fielded by the Appointment Coordination Unit (ACU). On occasion the requests go to the physician’s office coordinator or the front desk at each location; ultimately, all requests are forwarded to the ACU for resolution.

Schedulers seek open slots in surgeons’ existing schedules. If none is available but open rooms exist at the requested location, schedulers ask the provider or the provider’s office coordinator for permission to double-book and accommodate the patient. Alternatively, schedulers offer nurse practitioners who are available at the same location. If no providers at that location are available, then availability in other locations is offered using the same process.

The department accommodates same-day appointments in two ways:
Rearranging providers’ scheduled hours: In order to accommodate same-day appointments, especially for corporate partnership clients, Orthopedics has extended a provider’s scheduled closing hours from 5 p.m. to 7 p.m. on Mondays, which tend to be busiest for same-day appointment requests.

Requesting add-ons: This is a standing practice of providers’ opening times in their schedule for double-booking in their appointment time slots. Unlike rearranging the providers’ schedule this gives the scheduler flexibility to work with the providers, onsite staff and the Patient Access Manager to fit patients in where possible.