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 3 sub-problems described in the following presentation.

Upstream-downstream dependencies both between and within individual segments of the care itinerary further complicate the problem.  In such cases, five systems engineering concepts can help improve flow and delays.

This presentation describes these concepts in greater detail.  Teams participating in IHI's Specialty Access Innovation Community are currently experimenting with these concepts to learn how they can be adapted to their particular settings.  Further results and case studies will be posted here as they become available.