Big Access Week: Decreasing Dermatology Patient Wait Times in a Strained Healthcare System.
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BACKGROUND: New patient waitlists across the United States continue to grow. This trend is exacerbated in rural areas. Dartmouth Dermatology is a unique tertiary care center serving approximately 50,000 patients annually. In September 2023 the center's waitlist consisted of 3,654 unseen patients. METHODS: During Dartmouth Dermatology's Big Access Week, which took place December 11-15, 2023, the center saw 1,532 patients (1,180 new patients) using a four-pronged approach: categorization, community sensitization, patient expectations, and operations. RESULTS: Patient ages ranged from 10 months to 98 years. Average referral to visit time was 98.7 days. Full skin exams were performed on 406 patients, and focused exams were performed on 607 patients. Primary diagnoses included malignant/premalignant lesions for 279 patients, autoimmune-related skin disease for 57 patients, inflammatory lesions for 396 patients, and infectious lesions for 82 patients. Notably, 124 malignancies were confirmed (67 basal cell carcinomas, 39 squamous cell carcinomas, and 18 melanomas). Mohs referrals totaled 87 cases. The average patient satisfaction rating was 3.8/4. CONCLUSION: Dartmouth Dermatology's workflow model in Big Access Week significantly shortened waitlist time while maintaining high-quality care. This model can be implemented by a wide array of medical and surgical subspecialties, contributing to a seemingly daunting task: improving vital access to healthcare.