Tools
Literature
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Tools
A flow principle proven in other industries is to schedule work (i.e., appointments) in increasing order based on the consistency or variability in their durations. An Excel simulation has been developed that demonstrates this principle and the benefit of ordering the day’s work from smallest-to-largest variation (that is, schedule more predictable appointments earlier in the day).
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The complex problem of specialty access typically involves a sequence, or overall itinerary, of same-day visits (including diagnostic visits, treatment, follow-up, etc). Access and flow problems across this overall itinerary can be divided into three sub-problems described in the following presentation.
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A service agreement aims to get the work of access and flow between primary and secondary care. This is a tried and effective approach, but does require work.
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The Patient Journey Diagnostic Template is used to capture data on the patient experience from initial presentation to treatment.
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The Capacity and Demand Diagnostic Template is used to measure capacity (providers, exam rooms, appointments, etc.) versus demand of selected specialty practices or services.
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Literature
This article discusses the impact of managed care on mental health services. It reports that access to care has not decreased for people with the most serious conditions who were more likely to receive specialty mental health care after 2000. However, once people enter specialty care, the number of visits appears unrelated to need. The data highlights the urgent need for a greater focus on the quality of care and patient outcomes.
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This bibliography was prepared for the Institute for Healthcare Improvement's Innovation Community on Improving Access and Flow in Specialty Practices and Outpatient Settings.
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