{"id":67,"date":"2016-04-26T10:12:57","date_gmt":"2016-04-26T14:12:57","guid":{"rendered":"http:\/\/blog.camberry.ca\/?page_id=67"},"modified":"2016-05-25T12:12:47","modified_gmt":"2016-05-25T16:12:47","slug":"same-day-next-day-appointments","status":"publish","type":"page","link":"https:\/\/blog.camberry.ca\/?page_id=67","title":{"rendered":"Same Day \/ Next Day Appointments"},"content":{"rendered":"<p><strong><u>Timely Access to Care <\/u><\/strong><\/p>\n<p>Percentage of patients and clients able to see a doctor or nurse practitioner on the same day or next day, when needed.<\/p>\n<p><em>Direction of improvement: increase<\/em><\/p>\n<p><a href=\"http:\/\/blog.camberry.ca\/?attachment_id=66\" rel=\"attachment wp-att-66\"><img fetchpriority=\"high\" decoding=\"async\" class=\"alignnone size-full wp-image-66\" src=\"http:\/\/blog.camberry.ca\/wp-content\/uploads\/2016\/04\/timelyaccess.png\" alt=\"timelyaccess\" width=\"1079\" height=\"572\" \/><\/a><\/p>\n<p><strong>Summary\/Analysis<\/strong><\/p>\n<p>Recurring themes for improvement are: implementing advanced access principles and monitoring them.<\/p>\n<p><u>Effectiveness:<\/u><\/p>\n<p><strong>Bancroft ? <\/strong>use of the EMR to track and monitor patient appointments while understanding the supply and demand for appoints has improved access<\/p>\n<p><strong>Kawartha North<\/strong> ? tracking TNA weekly and monitoring trends for open access on an ongoing basis helps to determine if this approach is working sooner<\/p>\n<p>Aurora ? Newmarket ? focused on demand and supply and has advanced access 100 percent implemented, however their numbers dropped quite significantly.<\/p>\n<p>Health For All: Inclusion of a ?team based flowchart? for scheduling shows produced great improvement in numbers. However, they state increase in numbers may also be due to survey bias (surveying healthier and probably happier patients in waiting room)<\/p>\n<p>&nbsp;<\/p>\n<p><u>Recommendations:<\/u><\/p>\n<p>Implementing Advanced Access principles alone is not enough, improved measures come from monitoring the trends of doing so as well.<br \/>\nWorking at a team based approach to scheduling proved to be more effective in the case of Health for All.<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><strong>DETAILS<\/strong><\/p>\n<p><u>?<\/u><\/p>\n<p><u>Bancroft:<\/u>??? <em>66.00 ?&gt; 90.00<\/em><\/p>\n<ul>\n<li>Implement advanced access principles for all physicians and NP<\/li>\n<li>Understand demand and supply<\/li>\n<li>Increase supply of visits if necessary<\/li>\n<\/ul>\n<p>-&gt;<strong> Use EMR to track TNA, supply vs. demand, continuity, cycle time?s<br \/>\n-&gt; use EMR data to measure patients apt.?s annually<\/strong><\/p>\n<p><u>?<\/u><\/p>\n<p><u>Kawartha North:<\/u>??? <em>CB ?&gt; 65.34<\/em><\/p>\n<ul>\n<li>Continue to monitor TNA apt. which are non-consistent week to week and between providers<\/li>\n<\/ul>\n<p>-&gt; <strong>Track TNA weekly, identify change\/improvement opportunities, implement and evaluate on ongoing basis<\/strong><\/p>\n<ul>\n<li>Continue tracking IHPs to ensure ongoing and increasing ability to work at full scope and relieve pressure on primary care providers<\/li>\n<\/ul>\n<p>-&gt;<strong> Ongoing and increased staff communication to identify opportunities for IHPs to take on new\/additional responsibilities which will free up apt. time with primary care providers<\/strong><\/p>\n<ul>\n<li>Monitor effectiveness of open access times which have been added and appear to be improving patient access overall<\/li>\n<\/ul>\n<p>-&gt;<strong> weekly trend monitoring<\/strong><\/p>\n<p><u>Peterborough:<\/u>??? <em>40.30 ?&gt; 51.53<\/em><\/p>\n<ul>\n<li>Advanced Access Strategy: develop a plan to continuously monitor and report on patterns and balance of supply and demand\n<ul>\n<li>Plan to continuously monitor and report on patterns and balance of supply and demand was not initiated ? may be explored in future once QI committee is est.<\/li>\n<\/ul>\n<\/li>\n<li>Objective Access Metric: Use EMR to track and report TNA appointment\n<ul>\n<li>Bug still exist within PS Suite EMR regarding TNA ? Telus is aware and working to fix<\/li>\n<\/ul>\n<\/li>\n<li>Subjective Access Metric: revise patient experience survey to include exact HQO worded questions to improve consistency between FHOs and provincial FHT comparability<\/li>\n<\/ul>\n<p>-&gt; <strong>Add question wording from MoH technical specifications document<\/strong><\/p>\n<p>&nbsp;<\/p>\n<p><u>Trent Hills:<\/u> ????<em>47.00 ? 42.61<\/em><\/p>\n<ul>\n<li>Improve patient experience with ability to access primary care<\/li>\n<\/ul>\n<p>-&gt; <strong>Use advanced access and Efficiency Workbook to enhance accessibility, then re-measure patient experience after changes made<\/strong><\/p>\n<ul>\n<li>Use advanced access and efficiency workbook to:<\/li>\n<\/ul>\n<p>-&gt; <strong>Calculate roster balance; for each physician measure (DSA); adjust supply to meet internal and external demand; reduce backlog; adjust schedulers as needed; re-measure DSA<\/strong><\/p>\n<ul>\n<li>some data has been captured using these change ideas but scheduling changes have yet to be implemented<\/li>\n<li>have had a number of physician changes<\/li>\n<li>conflicting demands on physicians? time (increased demand at hospital, less time for clinic, having to cancel appointments)<\/li>\n<\/ul>\n<p><u>?<\/u><\/p>\n<p><u>West Durham:<\/u>????? <em>58.00 ?&gt; 52.16<\/em><\/p>\n<ul>\n<li>Identify root cause of health providers who have highest TNA available<\/li>\n<\/ul>\n<p>-&gt; <strong>EMR review of apt. schedule and booking types<\/strong><\/p>\n<ul>\n<li>Increase uptake of flu shots for all patients so demand for apt.s is reduced during flu season<\/li>\n<\/ul>\n<p><strong>-&gt; EMR data on flu shots given ? educate team members of importance of vaccination program<\/strong><\/p>\n<ul>\n<li>Skills development intervention ? educate admin staff on QI and advanced access apt. booking principles<\/li>\n<\/ul>\n<p>-&gt; <strong>examine adherence to TNA booking principles<\/strong><\/p>\n<ul>\n<li>Track amount of time providers give care over the phone (advice, triage)<\/li>\n<\/ul>\n<p>-&gt;<strong> Use EMR to track ?telephone advice? apt. type<\/strong><\/p>\n<p>Aurora ? Newmarket FHT: <em>85.00 ?&gt; 64.29<\/em><\/p>\n<ul>\n<li>Work to understand demand for care and supply<\/li>\n<li>Create a plan to more closely monitor provider loads and schedules and make adjustments as necessary<\/li>\n<li>We will work on understanding each providers schedule and their percent of pre-booked appointments vs. advanced access availability and modify this to suit our patient population based on feedback we receive<\/li>\n<li>Manage variation in demand by guiding pre-booked appointments to days where supply is greater than demand<\/li>\n<\/ul>\n<p>*based on patient perception and not actual data pulled internally. Advanced Access is at 100 percent<\/p>\n<p>&nbsp;<\/p>\n<p>Health For All FHT: <em>41.00 ?&gt; 62.07<\/em><\/p>\n<p><u>Experience:<\/u><br \/>\nStrength of survey ? quantitatively summarizes the experience of patients? access to clinic<br \/>\nWeakness of survey ? recall bias (patient responses depend on their memory and attitude related to past experiences)<\/p>\n<p><u>Key Learnings<\/u>: data on population surveyed suggests that a majority of patients responding believe they were in good health. This may be a selection bias in distributing the survey to healthier, more capable patients in waiting room.<\/p>\n<p><u>Impact of change Idea<\/u>: implementation and refinement of scheduling tools and process to include a ?team-based flow chart? approach to scheduling same-day urgent visits with providers and\/or residents when primary providers are not available. Greatest opportunity may lie in access to care (availability and continuity)<\/p>\n<p><u>Advice<\/u>: be mindful of selection bias and recognize other means\/methods for collecting patient satisfaction\/experience data (other than paper surveys)<\/p>\n<p>Southlake FHT: <em>CB ?&gt; 33.85<\/em><\/p>\n<ul>\n<li>Begin developing and creating a patient experience survey to measure how many days did it take for patients to see their healthcare provider when needed -&gt; adjust survey in future to narrow on particular physicians whose access is not same or next day<\/li>\n<li>Engage 4 more physicians to participate in the AA and E booking model (e.g. DM, GM, MMA, and OG) -&gt; working with Bradford satellite location to implement some advanced access methodologies<\/li>\n<li>Improved knowledge amongst staff and physicians by training them in AA and E modules -&gt; Bradford satellite office main goal is to make physicians? schedules so easy to book into that any receptionist can book into it which allows a more dynamic, diverse, and accessible office<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Timely Access to Care Percentage of patients and clients able to see a doctor or nurse practitioner on the same day or next day, when needed. Direction of improvement: increase Summary\/Analysis Recurring themes for improvement are: implementing advanced access principles and monitoring them. Effectiveness: Bancroft ? use of the EMR to track and monitor patient [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":85,"menu_order":1,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-67","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/blog.camberry.ca\/index.php?rest_route=\/wp\/v2\/pages\/67","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blog.camberry.ca\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/blog.camberry.ca\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/blog.camberry.ca\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/blog.camberry.ca\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=67"}],"version-history":[{"count":8,"href":"https:\/\/blog.camberry.ca\/index.php?rest_route=\/wp\/v2\/pages\/67\/revisions"}],"predecessor-version":[{"id":75,"href":"https:\/\/blog.camberry.ca\/index.php?rest_route=\/wp\/v2\/pages\/67\/revisions\/75"}],"up":[{"embeddable":true,"href":"https:\/\/blog.camberry.ca\/index.php?rest_route=\/wp\/v2\/pages\/85"}],"wp:attachment":[{"href":"https:\/\/blog.camberry.ca\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=67"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}