Improving Access to Care

Improving Access To Care

Over the past several years, we have done extensive work in the area of patient access to care and have developed some tools that we believe will be helpful in your pursuit of improving your clinical practice. We would like to share this information with you. These tools have been developed with the help of several clinical practices both nationally and internationally. As we continue to develop and refine these materials, we consider your input as valuable feedback for improvement. As you utilize these tools in your practice, we would welcome your comments. We love success stories and suggestions for improvement.

VAadvanced clinic accessVA Advanced Clinic Access

Prepared for the VHA by the Institute for Healthcare Improvement




ImprovingpatientaccesstocareImproving Patient Access to Care—Primary Care

It is through collaboration, learning, and many opportunities working with busy health care professionals that we are able to develop this workbook to help other professionals. We are grateful to the busy clinicians who are pioneers blazing new “access” trails to improve patient access to care. Key to improved patient access are clinical teams learning to cooperate in new ways with each other, optimization of support staff roles, improved processes and systems through practice redesign, and improved internal communication and cooperation in the clinical setting.

The collection of materials presented here has been developed over the past decade. Sources for these materials include Mark Murray, MD, MPA, Catherine Tantau, BSN, MPA, the Dartmouth-Hitchcock Health System and hundreds of teams across the United States, England, Sweden and Norway. We wish to continue to build on our collective experiences to help others learn about methods to better meet patient needs and improve patient access. We welcome your feedback.

MeasuringaccessimprovementMeasuring Access Improvement

The journey to improve access can be a difficult one. This journey requires us to think and act differently. It requires that we examine closely the way we have done our work, look for new ways of doing that work and testing, trying, implementing, refining, confirming and sustaining those changes.

But how do we know that all these changes and all this hard work resulted in improvement? We have to measure. Not only do we measure the old way, we measure the change and we measure the new way. Many groups and practices will adopt a philosophy of “ready, aim, implement!” These groups, if successful, have not only lost the opportunity to tell a great story, but have lost the opportunity to more fully understand that journey. In addition, they are left with a ship without a rudder- with no objective way to determine future improvement and to monitor for the sustainability of their hard won gains.

This book gives the ship a rudder, shows us what to measure and how to measure it. We don’t have to build a new rudder, we can simply use the principles outlined here. The principles around access improvement are relatively simple. It is simply a matter of demand and supply and the gap or delay between the initiation of the demand and the application of the resource or supply. We just need to balance the demand with the supply as soon as possible. But it is the implementation that is the difficult part. This book will take lots of the work and anxiety out of that implementation. It offers concise, easily used tools and techniques that add richness and clarity to our journey.