By Jacob Axelrad, Editor in Chief
Published May 13, 2012
Starting today, University Health Services is implementing changes including the discontinuation of walk-in appointments. Students seeking medical care on campus will have to schedule an appointment prior to when they need to be seen.
UHS Director Robert Winfield said in an interview with The Michigan Daily that UHS decided to eliminate walk-in appointments after assessing results of extensive surveys sent to patients over the past four years in order to make UHS more efficient.
The removal of walk-in treatment is one of two major changes — the other will be UHS’s switch from paper to electronic health records for patients, according to Winfield. While the entire University medical center will be making the switch to electronic records in mid-August, UHS was selected as one of three pilot sites to go live on June 13.
Winfield said patients will be able to use what’s known as a “patient portal” in order to access their medical records online with a personal sign-in code.
“The patient portal will be designed so that I could send you an e-mail and say, ‘Your lab test results are available on the patient portal,’ ” Winfield said. “Then you, having a code which we’ve set up for you at the time that you were seen, would go to the patient portal, sign in using your sign-on and get your results and what I thought about them.”
Winfield added that though UHS has conducted patient satisfaction surveys since the 1980s, it wasn’t until four years ago that surveys were expanded to include categories such as the waiting experience for patients, the cleanliness of the building and topics like diversity and privacy.
Winfield said UHS has responded to and improved upon many complaints voiced by patients regarding the clinic’s facilities, but added the issue they’ve been unable to address is the walk-in waiting experience.
“We were frustrated because we were having trouble getting satisfaction with our walk-in service above 85 percent among the students,” he said.
Winfield explained that the walk-in experience is generally worse for students than for University employees because of the different schedules kept by the two groups.
“Walk-ins for faculty and staff would occur earlier in the day because they tend to be a bit more organized and they don’t sleep until 11 or 12 or 1 o’clock,” Winfield said. “And by 11 or 12 or 1 o’clock, we were busy, and so walking in without an appointment was a bigger challenge for students than it was for somebody who walked in at 7:30 or 8 (a.m.).”
In August 2011, UHS devoted its entire first floor to walk-ins in an effort to accommodate the high number of walk-in appointments, while the third floor was used for scheduled appointments, according to Winfield.
“Making (walk-ins) work is very challenging because students … sometimes realize at kind of a late moment that they really ought to get seen because they’re feeling terrible,” Winfield said. “That often happens in the afternoon when we’re already booked, so it just creates this big wait and frustration.”
He said that because the first floor was changed to walk-in appointments only, the number of staff members working with walk-ins increased while those who worked with appointments decreased.
Winfield added that while the percentage of walk-in appointments rose from 40 to 60 percent, the satisfaction level decreased from 85 to 75 percent.
And by allocating more and more resources to walk-in patients, staff members found it difficult to see patients on a consistent basis because their time was dedicated to walk-ins instead of following up with patients, Winfield said.
“It fragmented care so that the person who saw them on walk-in might not be able to see them in an appointment two weeks later,” Winfield said. “It was increasing the length of the wait, and it just wasn’t working.”
Upon conducting another survey, UHS decided to switch to the appointment-only practice, which is already in use at schools such as the University of Iowa, according to Winfield.
“We surveyed the Big Ten and other health services, and over 50 percent are doing appointment-only,” he said. “So we said, ‘OK, let’s go ahead and give it a try this coming year (with) appointment-only.’ ”
Winfield explained when a patient now walks into UHS, he or she will be directed to an appointment clerk. If the clerk can’t assess the patient’s illness, a nurse will be brought in who will determine whether the patient’s condition warrants immediate attention or if they should be rescheduled for a later time.
Recent LSA graduate Chris Dietzel said he has had to wait two and a half hours for a walk-in appointment at UHS, but added he thinks there will be a level of convenience lost once the change is enacted.
“It was really cool just to know that I could literally walk in and be helped,” Dietzel said. “I definitely understand their reasoning, but it seems … convenient for them, but I don’t know if it’s convenient for us.”
Winfield said patients with issues deemed “less-than-urgent” but also “time-sensitive,” like a bad sore throat, will be seen within 24 hours or a week, depending on the circumstance.
He added that for “non-urgent issues,” which he described as anything from acne care to warts, patients could expect to be seen within three to seven business days.
Winfield said for serious conditions, such as appendicitis, mononucleosis or sexually transmitted infections, UHS would make it a priority to see patients as soon as possible.
“We just have to get those folks in, and we will do that,” Winfield said. “But we’re not going to do it the old way.”