Analysis of the Patient Appointing System of the 121st Combat Support Hospital to Determine an Optimal Appointing System

摘要

Kissick's Iron Triangle provides a model for health care delivery which postulates that the three goals of healthcare: quality, access, and cost containment cannot be simultaneously achieved. This is directly at odds with the latest continuous process improvement technique of Lean Six Sigma (faster, better, cheaper) which proposes that cost (cheaper) and quality (better) will increase if you increase access (faster). A centralized appointing system may be a method to increase access and quality while decreasing cost. The 121st Combat Support Hospital utilizes a centralized appointing system for primary care appointments while specialty care appointments are handled directly by the clinics. The purpose of this study is to take advantage of a unique opportunity to compare and contrast cost, quality, and access thereby assessing the effectiveness of a centralized appointment system in a single catchment area. By examining how the current appointment systems work and how they are designed to work, it will be possible to determine the best appointing system that will improve patient care by enhancing access and quality while decreasing cost.