Mallard 2004.

Methods	Study design: reanalysed ITS study Aim: to test the following propositions in support of same‐day scheduling, using actual data from a public health clinic: Same‐day scheduling will decrease patient waiting time to see a provider Same‐day scheduling will decrease the number of no‐shows at the clinic Same‐day scheduling will increase the number of new patients seeking services at the clinic Same‐day scheduling will increase provider productivity Timing: preintervention period: January 2001 to June 2001; intervention period: July 2001 to August 2001; postintervention period: September 2001 to February 2002 Data collection: not reported
Participants	Providers: paediatricians, nurses; number of providers not given Participants: outpatients calling for routine visits at a public paediatric health clinic; preintervention period: 4063 appointments and 78 new patients/mo; postintervention period: 3531 appointments and 95 new patients/mo Baseline characteristics of participants: Age: no information Gender: no information Ethnicity: no information Clinical problem: all conditions treated at the outpatient public paediatric health clinic (primary health care) Setting: outpatient paediatric clinic, urban Country: USA (state of Alabama)
Interventions	Type of intervention: intervention aimed at restructuring the referral process Intervention: open access/same‐day scheduling: 30% of participants on prescheduled appointments, 70% booked on same day of telephone call; only 3 types of appointments (routine exam, ill patient, recheck); same length of time for all appointments; cap on total number of participants to be seen in a day; no double booking allowed; appointment clerks started an hour earlier; participants calling were asked whether they were willing for same‐day appointment or should call another day; 3531 appointments Control: complex appointment guidelines to differentiate need for appointment scheduling; many participants walking in despite a no‐today‐appointment answer. Appointments made on the basis of next place available; 4063 appointments Duration of intervention: 8 months
Outcomes	Mean waiting time from call to visit (outcome included in review) Attendance rates Number of new patients Provider productivity
Notes	‐
Risk of bias
Bias	Authors' judgement	Support for judgement
Intervention independent of other changes (ITS)?	Low risk	Quote: "Since the first two months following the initiation of the project were already booked according to the prior guideline, the clinicians doubled up and saw both the existing appointments and the same‐day scheduled patients" Comment: Nevertheless, as analysis of data excluded the period of extra activity, risk of bias is presumed to be low
Analysed appropriately (ITS)?	Low risk	Reanalysed as ITS
Shape of the intervention effect pre‐specified (ITS)?	Low risk	Data reanalysed by review authors
Intervention unlikely to affect data collection (ITS)?	Unclear risk	No information given on data collection
Knowledge of the allocated interventions adequately prevented during the study (ITS)?	Low risk	Outcomes objective; thus unlikely to be affected by a possible unblinded assessment
Incomplete outcome data addressed (attrition bias) (ITS)?	Unclear risk	No information given
Free of selective outcome reporting (reporting bias) (ITS)?	Unclear risk	Study protocol not available ‐ so outcomes reported in the paper cannot be checked against any prespecified outcomes
Free of other bias (ITS)?	Unclear risk	Unclear definition on how waiting time was calculated; unclear also how waiting time for prescheduled appointments contributed, i.e. appointments for which shorter wait time presumably was not desired