Enhancing Primary Healthcare through Advanced Access Strategies

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Explore how Health Quality Ontario (HQO) is promoting accessible and efficient care in primary healthcare with a focus on chronic disease management. Learn about the importance of advanced access, reducing delays, and improving patient-provider interactions for better healthcare outcomes. Discover innovative strategies and insights to optimize healthcare delivery.

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WAVE 6 Advanced Access, Efficiency and Chronic Disease Management in Primary Healthcare Date: Name of Presenter: www.HQOntario.ca

WAVE 6 Agenda Introduction About Health Quality Ontario Introduction to Advanced Access Overview of the Learning Community Overview of Wave 6 Questions & Discussion www.HQOntario.ca 1

Health Quality Ontario (HQO) HQO is an independent agency created by the Government of Ontario to: (a) monitor and report; (b) support continuous quality improvement; (c) promote health care - supported by the best available scientific evidence. 2

Accessible Care People are able to get the right care at the right time in the right setting by the right health-care provider 3

Waitingfor a Family Physician in Ontario % of adults able to see their GP same or next day 2011 report on Ontario s Health System; HQO 4

Delays are common in our system: Delay Delay Delay Getting to GP Getting Tests Seeing Specialist Dissatisfaction, adverse clinical outcomes, increased costs 5

How Are You Doing? Patients have trouble booking appointments? Receptionists say no a lot? Feel overwhelmed with demand? Find it difficult to bring patients back for follow-up? Experience a lot of no shows ? 6

What is Advanced Access? Timely patient access to a scheduled appointment Measured in days: Third Next Available Appointment (TNA) Excellent access is when a practice can accommodate a patient s day & time of choice with his or her primary care provider 7

Advanced Access is about Reducing delay Patients see their provider on their day of choice Doing today s work today Matching provider supply to patient demand Improving the patient/provider/team experience 8

Access is not about Limiting patient s ability to book in advance Prioritizing access over continuity Making you work harder/ faster/ longer Promoting a walk-in culture Unleashing limitless demand 9

Moving Towards Advanced Access 10

Access to care can be improved. By understanding and balancing your Demand and Supply Demand Supply (From your panel) (By your care team) 11

First, consider your annual Demand & Supply How many appointments are requested by your patients in a year? How many appointments do you offer in a year? Appointments/week x weeks worked/year Panel size x revisit rate Demand Supply 12

Next, measure your Demand and Supply on a daily basis 13

Demand From your panel External Demand Internal Demand How many people ask for an appointment each day? Mon I I I I I I I I I I Tues I I I I I I I I I Wed I I I How many return visits are booked? I I I I I I Thurs I I I I I I I I I Fri I I I I I I I I 14

Supply By your care team Total Demand Supply How many # Mon # appointments are Tues # # # Wed offered each day? # Thurs # # Fri # # 15

Does Demand balance with Supply? If not, test changes until a balance is achieved. Balancing Supply and Demand involves examining the way you deliver care and takes time. For ideas on how to test changes to achieve a balance, visit the Learning Community Gateway www.hqolc.ca 16

Once the care team has balanced Supply & Demand Reduce your backlog How large is your backlog? 17

To Measure Backlog: 1. Count number of booked appointments between now and the third next available appointment (TNA) 2. Subtract Good Backlog 3. Add temporary supply to catch up until provider/care team is doing today s work today 18

Going forward, offer Supply that matches Demand = 19

Maintaining Access requires matching supply to demand daily & weekly External Demand Internal Demand # # # # # # # Mon # # Tues # # # # # # Wed # # # Thurs # # Mon Tues Wed Thurs Fri Fri 20

Important Strategies 1. Booking Appointments: Offer an appointment today, or if patient requests, another day. Book return visits early in the day and late in the week. 2. Maintain Good Access to Care Contingency plan for variation Continue testing improvement ideas and measuring 21

6 Principles of Access 1. Understand and Balance Supply and Demand 2. Increase Supply of Visits 3. Reduce Demand for Visits 4. Reduce Appointment Types and Times 5. Reduce Backlog 6. Develop Contingency Plans 22

Case Studies with Advanced Access 25 20 Days till 3rd next Available Appt 15 10 5 0 Month 1 Month 2 Month 3 Month 4 Month 5 Month 6 Month 7 Month 8 MD1 MD2 MD3 23

6 Principles of Efficiency 1. Balance supply and demand of non-appointment work 2. Synchronize patients, providers, information, rooms and equipment 3. Anticipate and predict patient needs 4. Optimize rooms, staff and equipment 5. Manage constraints 6. Eliminate waste 24

Whats in it for me and my patients? Improved patient satisfaction Improved physician and staff satisfaction Improved ability to organize care processes and continuity of care Less cost to healthcare system 25

Challenges Measurement Engaging staff Change Sustainability and Spread 26

Learning Community: 3 Main Elements Active Learning Cycles Model for Improvement, CDPM Framework Clinical Practice, Evidence-based Guidelines Infrastructure Gateway A virtual on line real-time workspace Support QI coach 27

Benefits of a Learning Community: Learn Learn Share Share Learning Community Innovate Improve Innovate Improve 28

WAVE 6 Access plus Chronic Disease Management Growing population in Ontario Demanding on primary care and all levels of health care Improvements in primary care can impact: Patient outcomes Entire system of care Better patient transition between levels of health care improves patient experience. 29

WAVE 6 Wave 6 Highlights Starts March 20th,2013 9 month + 3 months data collection Apply until March 1st, 2013 Readiness assessment required Coach support by stream Team obligations 30