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Shared Medical Appointments: Balancing Efficiency With Patient Satisfaction and Outcomes
Shelly P. Smith, DNP, APRN-BC, and Beth L. Elias, PhD, MS
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Shared Medical Appointments: Balancing Efficiency With Patient Satisfaction and Outcomes

Shelly P. Smith, DNP, APRN-BC, and Beth L. Elias, PhD, MS
Shared medical appointments have the potential to improve clinic efficiency, patient outcomes, and patient satisfaction when managing chronic rhinosinusitis.
A challenge also existed with the automated appointment reminder system. The NSSMA had an allotted 90-minute block in the schedule; however, individual patients were listed at separate times during that block, which prompted the automated service to remind patients of the incorrect start time. Similar barriers were identified in a study by Johnson and Raterink when implementing a diabetes clinic within their family practice program.15

A third challenge involved physical space. A conference room served as space for the appointments; however, when this room was not available, the flow of the NSSMA was negatively affected. The shift in location caused problems with scheduling, as well. The highest-volume week day was no longer a feasible day to offer the NSSMA, making it less likely to reach capacity.


The SMA provides an opportunity for efficient healthcare delivery that maintains or increases quality and patient satisfaction. Patient-centered care requires that providers give patients timely access to care and a choice about services rendered—the SMA allows for both. Examples of potential opportunities for SMA include global charge visits, transitional care appointments, extended teaching opportunities, and visits that include caregiver support.

Global charge visits are not directly reimbursed, as the fee is included in the physician’s surgical fee; postoperative SMA would free up time for reimbursable appointments. Transitional care is also challenging due to the time constraints placed by CMS; the SMA would allow multiple patients to be evaluated simultaneously, while fostering a sense of patient community. For busy practices managing large panels, the SMA serves as an opportunity to balance cost and quality. 

Author Affiliations: Department of Adult Health and Nursing Systems, Virginia Commonwealth University School of Nursing (SPS, BLE), Richmond, VA.

Source of Funding: None.

Author Disclosures: The authors report no relationship or financial interest with any entity that would pose a conflict of interest with the subject matter of this article.

Authorship Information: Concept and design (SPS); acquisition of data (SPS); analysis and interpretation of data (SPS); drafting of the manuscript (BLE, SPS); critical revision of the manuscript for important intellectual content (BLE, SPS); statistical analysis (SPS); provision of patients or study materials (SPS); administrative, technical, or logistic support (BLE, SPS); and supervision (BLE).

Address correspondence to: Shelly P. Smith, DNP, APRN-BC, Clinical Assistant Professor, Department of Adult Health and Nursing Systems, Virginia Commonwealth University School of Nursing, 1100 E. Leight St, Richmond, VA 23298. E-mail:

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