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Getting Started: How to Improve

Learn about the Model for Improvement, forming the improvement team, setting aims, establishing measures, and selecting and testing changes. Go to How to Improve.

Primary Care Access

​​​​​​​​Improving access is all about getting supply and demand in equilibrium, which means that there is no backlog of appointments and no delay between when the demand is initiated and when the service is delivered. The gap between supply and demand not only contributes to a delay in meeting patients’ needs, but it can also be expensive and generate waste in the system.

The experience of many health care organizations demonstrates that demand is not really insatiable, but actually predictable. In fact, the demand for any kind of service — appointment, advice, or message to a provider — can be predicted accurately based on the population, the scope of the provider practice and, over time, the particular practice style of each provider. Periods of high or low demand can be anticipated, based on an analysis of demand data collected on all requests coming into the system. An improved access system uses these predictions as the framework to match its supply to the needs of a population of patients for any specific service.

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  • Backlog Reduction Worksheet
    The “backlog” of your practice consists of patients waiting to be scheduled or patients who have been put off into the future. Often in primary care, the list is composed of patients waiting for physicals, new patient visits, or follow-ups.
  • Practice Supply Worksheet
    "Supply" in an office practice is the number or Full Time Equivalant (FTEs) of physicians, associate providers, RNs, MAs, LVNs, LNAs available in the practice to provide patient care.
  • 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
  • Today's Office Visit Survey Card
    This four-question survey card is used to retrieve quick feedback to determine patient satisfaction for today's office visit.
  • True Demand Formula
    The True Demand Formula is an easy-to-use tool to determine the true patient demand, both internal and external, in your office practice.
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  • 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.
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