Third next available appointment (TNA)

What is TNA? 

The third next available appointment is a measure that looks at the average length of time, in days, from when a patient requests an appointment to the third next available appointment open in the provider’s schedule.  

The third next available is used rather than the next available appointment because it is a more accurate reflection of true availability of the provider. Days when the clinic is closed, like weekends and holidays, are counted because it reflects the patient experience. 

How to measure TNA

The steps in measuring a provider’s TNA:

1. Determine the length of the shortest appointment block and only measure these.
   
   
2. Do not count any short appointment slots that can only be booked for a specific reason (you may hear these referred to as carve outs).
   
   
3. Count the number of days until you find the third next available short appointment including days the clinic is closed.
   
   
4. Record the value.

Practice tips

Measure TNAs on the same day, at the same time, every week. Tuesday at 10 a.m. is a good time.

It can be helpful to track TNAs in a tool that can show data over time, so you can track progress and trends.

Case Study 

Let’s calculate the TNA for a provider in this sample clinic: 

If we are counting at 10 a.m. on a Tuesday, the third next available appointment is Monday at 9:30 a.m. = TNA of 6 days