Grantee Spotlight from Nevada

Rethinking Scheduling to Improve Patient Satisfaction in Carson City


Before, we were scheduling appointments, taking walk-ins, and double booking. We now have higher patient and staff satisfaction by getting patients in sooner, especially patients with symptoms. We’re not having them schedule three weeks out
Roni Galas, Clinical Services Manager, Carson City Health and Human Services
Carson City waiting room before improvement. Cluttered waiting room with no flow.
Carson City waiting room after improvement. Clean, streamlined waiting room.

The staff at Carson City Health and Human Services in Nevada wanted to improve clinic efficiency, decrease the rate of no-shows in their clinic, and boost staff and patient satisfaction. The entire staff came together to develop an improvement plan. They began by reviewing their scheduling, utilization, and patient satisfaction data on the Clinic Efficiency Dashboard, and identified changes based on evidence-based strategies as described in the Clinic Efficiency Quality Improvement Guide. They conducted a Clinic Flow Assessment and mapped clinic flow. Staff elected to adopt an advanced-access scheduling system for patients to be seen on the same or next day that they call for appointments. The staff also decided to modify the clinic layout to optimize the use of a clinic exam room; move supplies and lab materials to improve the flow of staff and patients within the clinic; and make the waiting room more patient-centered.

Within six months of making these changes, Carson City reduced its no-show rate from 34% to 21%, and increased the average number of patients seen per day by 13%. Clinical staff said they were pleased to be able to see patients with higher acuity symptoms sooner. Using the Plan Do Study Act approach, staff will test additional changes on an ongoing basis to increase both patient and staff satisfaction.