Overcoming Capacity Management Challenges in Patient Access

How Healthcare Organizations Can Address Staffing, Scheduling, and Operational Hurdles To Improve Access and Efficiency

Patient access is one of the most critical priorities for healthcare organizations, yet achieving it remains a persistent challenge. A recent survey conducted by Tegria, in partnership with the College of Healthcare Information Management Executives (CHIME), revealed that capacity management continues to significantly limit patient access. In fact, all but one respondent cited capacity management as having a moderate or significant impact on their ability to meet patient demand.

This article delves into the reasons behind these challenges and explores the operational hurdles healthcare organizations face. It also highlights strategies organizations can employ to overcome capacity management barriers, ultimately improving access, patient experiences, and organizational performance.

58% of organizations surveyed are already in process with patient access initiatives.

The Scope of the Capacity Management Challenge

Capacity management involves optimizing the availability of clinicians, scheduling processes, and resource allocation to match patient demand. The survey findings underscored the magnitude of this issue, with limited clinician availability emerging as the most commonly cited barrier to access. Respondents from both large and small healthcare organizations highlighted staffing shortages as a critical constraint, with one rural health provider noting, “We have extreme difficulty in recruiting providers to some of our service areas, which has severely impacted patient access to care in those communities.”

Geographic challenges, particularly in rural areas, compound this issue. Many organizations struggle to recruit and retain qualified clinicians, making it difficult to provide timely care. Even organizations with advanced digital tools reported significant barriers, demonstrating that technology alone cannot solve capacity management challenges.

Operational Hurdles Impacting Patient Access

Beyond clinician availability, operational inefficiencies present additional barriers to patient access. The survey identified several key hurdles, including:

• Insufficient staffing levels: A frequent challenge across organizations of all sizes.
• Poor communication among teams: This was consistently cited as a factor that exacerbates inefficiencies.
• Inefficient scheduling systems: Some organizations noted a lack of integration and granularity in their scheduling tools, which limited their ability to effectively match clinician supply with patient demand.

One respondent highlighted the difficulty of using historical data to improve future access, noting, “The hardest thing to overcome is anecdotal comments around capacity and appointment times. There is limited ability to analyze past performance to help improve future access opportunities.”

These operational barriers underscore the need for a holistic approach to patient access that addresses both supply-side constraints and workflow inefficiencies.

17 out of 24 respondents indicated they expect a positive ROI for patient access initiatives.

Improving and Aligning Operations With Technology

While technology alone cannot resolve patient access issues, aligning it with operational strategies can amplify its impact. Many survey respondents noted that their technology solutions—such as scheduling systems and patient portals—are partially integrated, leaving significant room for improvement. To enhance alignment:

• Invest in Interoperability: Ensure that digital tools seamlessly connect across departments, enabling data sharing that supports better decision-making and resource allocation.
• Provide Ongoing Training: Equip frontline staff and operational leaders with the skills to effectively use technology. As one respondent noted, “We can put all the tools in front of them to use, but if they don’t know how to use it or don’t want to learn, it won’t improve the balance.”
• Integrate Price Transparency: Clear, timely estimates and billing create a more seamless experience that aligns financial and operational goals. Align pricing tools with scheduling and billing systems to ensure consistent communication between providers, patients, and revenue cycle teams.
• Focus on Change Management: Implement structured change management strategies to ensure smooth adoption of new technologies and workflows. Leadership engagement and communication are critical to overcoming resistance and ensuring alignment with operational goals.
• Leverage Data Analytics: Use advanced analytics to identify bottlenecks, predict patient demand, and monitor the effectiveness of access initiatives. Data-driven insights can guide process improvements and technology upgrades.

By aligning technology and operations, healthcare organizations can create a cohesive approach to capacity management that addresses both process inefficiencies and patient needs.

Strategies To Improve Capacity Management

While the challenges are significant, there are actionable strategies healthcare organizations can adopt to address capacity management issues and improve patient access:

1. Enhancing Clinician Availability: Organizations must prioritize recruitment and retention strategies, particularly for rural and underserved areas. Advanced workforce analytics can help predict demand and optimize clinician schedules, ensuring the right resources are in place at the right time.
2. Standardizing Referral Management: Implement clear, standardized processes to ensure timely and accurate referrals, reducing bottlenecks and improving care coordination. By optimizing referral management, healthcare organizations can reduce wait times, enhance patient satisfaction, and ensure more effective use of available clinical capacity.
3. Streamlining Scheduling Processes: The survey highlighted gaps in scheduling tools, particularly their lack of granularity. By investing in predictive scheduling systems that integrate with other operational tools, healthcare organizations can better balance patient demand with clinician availability.
4. Improving Team Communication and Collaboration: Respondents emphasized the importance of leadership in driving operational changes. One survey participant stated, “Ownership, communication, and collaboration from the start—and from the top down—are key to transformation.” Fostering cross-team collaboration and engaging clinical and operational leaders can help organizations break down silos and implement effective patient access initiatives.

The Path Forward

Capacity management is not just an operational challenge—it is a critical factor in patient satisfaction and outcomes. While technology plays an important role, the survey findings reveal that process inefficiencies and staffing challenges are often at the root of the problem.

To overcome these barriers, healthcare organizations must focus on leadership engagement, workforce development, and process improvements. A holistic approach that combines operational efficiency with technology will enable organizations to provide timely, equitable access to care.

With more than 58% of survey respondents already in the process of implementing patient access initiatives—and 17 of 24 anticipating a positive return on investment—there is reason for optimism. By addressing capacity management head-on, healthcare leaders can pave the way for a more accessible and patient-centered future.

SOURCE: Tegria