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Health Improvement Partnership of Santa Cruz County: A Triple Aim Improvement Story
This Triple Aim improvement story examines the work of one community pursuing a regional focus to improve population health, and the backbone organization that established the Triple Aim as its guiding framework for improving health outcomes of those served by safety net clinics, with a focus on vulnerable populations — in particular, low-income childless adults, undocumented people, and young entrepreneurs — all of whom had little or no access to health care.
WIHI: The Echo Effect of Project ECHO's Access to Specialty Care
July 9, 2015 | There’s telemedicine, and then there’s Project ECHO. What began in 2003 as a process for improving access to treatment for people in New Mexico suffering from Hepatitis C, now offers support and learning for 30 different diseases and conditions, impacting patients in some 22 states.
WIHI: Disability Competent Care
June 11, 2015 | A lot of progress has been made the past several decades for people with disabilities. But, there are still barriers and biases that prevent disabled individuals from leading full lives and fully accessing health care.
WIHI: The Road to Team-Based Primary Care and Behavioral Health
December 4, 2014 | Primary care practices across the US are facing a number of important challenges right now; prominent among them is doing a much better job at recognizing and helping patients with behavioral health issues.
WIHI: New Staffing Models for Primary Care
October 10, 2013 | This WIHI looks at ways that primary care practices can delegate responsibilities and work as a team — one of the central needs for all primary care providers today. We also take a look at the LEAP project (Learning from Effective Ambulatory Practices) and discuss success factors that LEAP has identified thus far.
Scorecard on State Health System Performance for Low-Income Populations
Analyzing 30 indicators of access, prevention and quality, potentially avoidable hospital use, and health outcomes, the scorecard documents sharp health care disparities among states.
Mobile Clinic in Massachusetts Associated with Cost Savings from Lowering Blood Pressure and Emergency Department Use
A study of 10,509 patient visits to the Family Van, an urban mobile health clinic in Massachusetts, found that screenings and counseling resulted in significant reductions in high blood pressure from 2010 to 2012. The researchers argue that mobile health clinics are an effective delivery model for underserved communities with poor health status and frequent use of emergency departments.
Using a Campaign Approach Among Health Workers to Increase Access to Antiretroviral Therapy for Pregnant HIV-Infected Women in South Africa
A campaign approach among health workers to improve access to antiretroviral therapy (ART) for HIV-infected pregnant women in two districts in South Africa shows a four-fold increase in HIV-infected women initiated on ART.
The Physician Shortage and Implementing the Affordable Care Act
In this Boston Public Radio program, IHI COO Jeffrey Selberg and Harvard School of Public Health professor Meredith Rosenthal discuss the impending shortage of general care physicians and how it will affect the implementation of the Affordable Care Act.
Geographic Variation in Access to Care: The Relationship with Quality
This article highlights wide geographic variations in access to care, including preventive care, and notes that communities with better access to care generally also have higher quality care.
Resources for Public Health Quality Improvement
A collection of resources to help public health leaders and practitioners apply quality improvement to programs and processes, with the ultimate goal of saving lives, cutting costs, and getting better results.
WIHI: Organizing for Health: A Story from South Carolina
November 3, 2011 | Businesses, insurance companies, local hospitals, municipal offices, professional schools, and others in Columbia, South Carolina, are working together as a community to improve the wellness of citizens and increase access to primary care.
Appointment Sequence Simulation
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).
Clinica Campesina: Where Patients with Asthma See a Member of Their Own Clinical Team Nearly 90 Percent of the Time
Knowing the positive impact that continuity of care has on patient engagement, satisfaction and outcomes, Clinica Campesina uses several approaches that support continuity: consistent provider teams, open access scheduling, and group visits.
Improvement Report: Improving Access to Orthopedic and Cardiology Appointments
Veterans Health Administration (Loma Linda, California, USA) aimed to reduce the waiting time for new appointments in Orthopedics from 200 to 300 days to 30 days and for Cardiology from 42 to 14 days.
Open Access at Primary Care Partners
"If you want to double your take-home pay, work less hard, and have happier staff and patients, this is the way," says family practitioner Gregg Omura, MD. Since implementing open access scheduling in his practice, along with some other improvements that support it, Omura has increased patient visits by 22%, increased gross revenue by 32%, increased net revenue by 87%, and decreased "no-shows" from about 1.9 per day to 0.75 per day.
A Culture of Change at ThedaCare
ThedaCare's culture of change has supported improvements on every front, from inpatient care to office-based care in their clinics. And it is here, in practice redesign, that ThedaCare has really made change a way of life.
Improvement Report: Iowa Health System's Improvements in Office Practices
Iowa Health System (Des Moines, Iowa, USA) focused on improving the six quality dimensions from the Institute of Medicine's Report, Crossing the Quality Chasm.
Overhauling the Office Practice at CareSouth Carolina
CareSouth Carolina (Hartsville, South Carolina, USA) is working diligently to improve care for patients by setting ambitious goals to make improvements in six essential areas in its office practices.
You've Come a Long Way: Advanced Clinic Access in the Urology Department
Before Advanced Clinic Access (ACA) came to the VA Urology Clinic in Fargo, North Dakota, patients and providers were frustrated by the long waits and clogged appointment schedules that were typical of the system. Patients waited an average of 90 days to get an appointment to see the urologist. Urology clinics were booked solid every day, with several slots double-booked.
Advanced Clinic Access: Getting to the Heart of the Matter in Cardiology
The Cardiology Clinic at the Cincinnati Veterans Administration (Cincinnati, Ohio, USA) has made tremendous changes to achieve open access by shaping the demand for patients being referred to cardiology. Waiting times for all appointment types decreased from 70 to 80 days in May 2000, to an average of less than 18.3 days in November 2002.
Shortening Waiting Times: Six Principles for Improved Access
Assembly line medicine? Mark Murray, a former assistant chief of medicine for Kaiser Permanente, says that bringing the lessons of streamlined industries into health care is the way to reduce waiting times and improve access
Making Advanced Clinic Access Work at the Amarillo VA Health Care System
The Amarillo VA Health Care System (Amarillo, Texas, USA) decreased the overall wait time for primary care appointments from 76 days to 20 days by using the Advanced Access concepts.
Improving Patient Access: Everett Clinic
Everett Clinic (Washington, USA), implements Open Access through IHI's IMPACT network and reduces the time for the third next available appointment to within 24 hours. The implementation of Open Access has also improved their patient satisfaction scores 30 percent.
Streamlining the Office Practice: Naval Hospital Pensacola
Naval Hospital Pensacola (Pensacola, Florida, USA), improves access and efficiency through IHI's Office Practice Collaborative. The clinic was able to increase the number of patients seen per month, while reducing the time spent in clinic for patients.