2011 Patient Centered Medical Home Monthly Webinar Series. Before we get started…. If you have questions during the webinar, please type them in for the presenter. After the presentation we’ll open up the phone lines for our interactive question and answer session.
Let’s get started.
Gretchen Geist, RN; BSN
Brad Meyers, MD
Same-day scheduling, also called advanced access or open access, is a method of scheduling in which all patients can receive an appointment slot on the day they call, almost always with their personal physician. (AHRQ)
The goal is to reduce or eliminate wait times both for appointments and at the time of the appointment.
Mark Murray, MD
**Must Pass Element CF=Critical Factor MU=Meaningful Use
Practice has written process/standards and demonstrates that it monitors performance against the standards to:
Take action using closed loop feedback process with these or similar steps:
*Adapted from six sigma DMAIC steps
(mini-testing cycles to find best fit)
6) Monitor and measure outcomes
*Adapted from six sigma DMAIC steps
A principle is the beginning of an action.
3) Reduce the number of queues
↑ Demand or ↓ Supply
…places that function most like a system are most successful. By system I mean that the diverse people actually work together to direct their specialized capabilities toward common goals for patients. They are coordinated by design. They are pit crews. To function this way, however, you must cultivate certain skills which are uncommon in practice and not often taught.~Atul Gawande, MD from commencement address, Harvard Medical School May 2011
Practice provides patient care services by:
Domain 1: Values/Ethics. Work with individuals of other professions to maintain a climate of mutual respect and shared values.
Domain 2: Roles/Responsibilities. Use the knowledge of one’s own role and those of other professions to appropriately assess and address the healthcare needs of the patients and populations served.
Domain 3: Communication. Communicate with patients, families, communities, and other health professionals in a responsive and responsible manner that supports a team approach to the maintenance of health and treatment of disease.
Domain 4: Teams and Teamwork. Apply relationship-building values and the principles of team dynamics to perform effectively in different team roles to plan and deliver patient-/population-centered care that is safe, timely, efficient, effective, and equitable.
Take the time to do it well
Teach others by example
Agency for Healthcare Quality and Research. http://www.cahps.ahrq.gov/QIguide/content/interventions/OpenAccessSchedulingforRoutineandUrgentAppointments
Green, L., & Savin, S. (2008). Reducing delays for medical appointments: A queuing approach. Operations Research, 56(6), 1526-1538.
Institute for Healthcare Improvement (IHI). Primary care access. Retrieved from http://www.ihi.org/IHI/Topics/OfficePractices/Access/
Interprofessional Education Collaborative Expert Panel (2011). Core competencies for IP collaborative practice: Report of an expert panel. Washington, DC: Interprofessional Education Collaborative.
Murray, M. (2005). Answers to your questions about same-day scheduling. Family Practice Management, 12(3), 59-64.Retrieved from http://www.aafp.org/fpm
National Committee for Quality Assurance (NCQA, n.d.). Patient Centered Medical Home Standards Workshop 2011. Retrieved from http://www.ncqa.org/
Rose, K., Ross, J., & Horwitz, L. (2011). Advanced access scheduling outcomes. Archives of Internal Medicine (online version) doi:10.1001/archinternmed.2011.168