Third Next Available Appointment

How long do your patients have to wait for an appointment? The longer your patients have to wait, the less satisfied they will be with your service. If you maximize the efficiency of your practice, you can keep your patient’s happy while also improving your quality of care, minimizing your no-show rate, and improving your patient access.

Even though there are plenty of metrics you can track that can tell you how long your patients are waiting, one of the best metrics you should be using is the third next available appointment. 

What Is the Third Next Available Appointment?

The third next available appointment (TNAA) is a measurement of how long it takes your patients to access providers when they want to schedule an appointment. You might have already used other metrics to track how long your patients are waiting, but the TNAA is often the most accurate. 

The next available appointment might have become available due to a cancellation, or even the second next available appointment might have become available due to an unforeseen event. As a result, these two metrics are not as reliable.

Ideally, the time to your third next available appointment should be either the same day or one day. If there are more part-time providers in your practice, then the time to your third next available appointment might exceed one day; however, if the wait time is too long, your patient satisfaction rates and your quality of care could begin to suffer.

Why Use Third Next Available Appointment?

There are several reasons why you should track your third next available appointment. These include:

  • If your third next available appointment is too far out, there might be a serious delay in patient care, impacting your health outcomes. It could also mean that you have a high rate of walk-ins and no-shows. 
  • A good TNAA time could indicate there is a good balance between demand for your providers and provider capacity.
  • Tracking your third next available appointment can help you make sure to take full advantage of the patient care team, ensuring follow-ups are handled smoothly.
  • If you know your TNAA, you can also take advantage of alternative methods to see patients and reduce demand on your providers. This could include phone calls and email follow-ups. 

Ultimately, tracking your TNAA can give you greater insights into how your practice is operating and how efficiently you are seeing your patients. That way, you ensure you are meeting their needs in a timely manner. 


How To Measure TNAA

You should measure your third next available appointment time for each provider regularly. The steps you need to follow to measure your TNAA properly include:

  • Measure the TNAA for each provider to get an accurate picture of patient access across the entire practice.
  • You should try to have the same person run the measurement every week. That way, you know the process for measuring the third next available appointment will always be the same.
  • As you measure your TNAA, try to choose the same day of the week and the same time of day to measure this metric. This can help you eliminate some confounding variables. 

Remember that you should always include days off, holidays, and weekends when tracking TNAA. This allows you to compare patient wait time accurately across multiple providers. If there is a held or blocked time slot for an emergency, you should not include this in your calculation. 

How To Record TNAA

When you want to record the third next available appointment, there are several steps you need to follow. They include: 

  • Select a provider and open the scheduling system.
  • Take a patient request and see when they made the appointment.
  • Then, count the number of days between the request and the third next available appointment. If there is an appointment available today, that counts as zero days. If the third available appointment is tomorrow, that counts as one day. 
  • Include days off such as weekends and holidays. Do not include blocked time for urgent visits and emergencies.
  • Do this for every provider once per week. You should do this for new visits and return visits for each provider. 
  • Average the TNAA across the entire practice.

It is helpful to use a TNAA worksheet to track your information. That way, you can watch appointment wait times change as the weeks go by. While many thriving practices have a TNAA time between zero and one day, this can vary depending on the nature of the practice and its specialty. You may want to take a look at this worksheet to see how you can more easily track your results. 

a man holding a clock

How To Evaluate Success

There are many healthy practices that have a third next available appointment time of zero days or one day. Some successful practices may have a TNAA of two days. Every practice is different, each practice needs to have its own patient access standards. 

For example, there are some patients with chronic medical conditions that should not have to wait very long; however, someone coming in for a routine visit may still be satisfied even if they cannot see a doctor within two days of requesting the appointment. 

Keep in mind that there is also a complicated relationship between supply and demand. If the TNAA wait time is too long, increasing the number of available appointments will not necessarily reduce this metric if there is a specific doctor who is always in demand. You need to take a look at the data to figure out which doctors have longer TNAAs and why this is the case.

A few ways you can improve TNAA include:

  • You may need to redistribute your patients more evenly among clinicians, particularly if new providers have lots of open appointments and more experienced providers have long wait times. 
  • You can extend the hours that the clinic is open to increase the number of available appointments.
  • You may want to encourage more patients to use the self-scheduling patient portal to increase the number of used appointments and reduce the number of open slots. 

Consider following a few of these tips if you want to shorten the average patient wait time for an appointment.

Maximize Practice Efficiency By Tracking Third Next Available Appointment

If you want to maximize the efficiency of your practice, you need to track the third next available appointment. This is largely seen as a more accurate measurement of how long your patients have to wait for an appointment when compared to the next available appointment or the second next available appointment. Try to calculate the TNAA for each provider once per week to improve patient access and satisfaction.