Advanced Access Scheduling in Primary Care

2020 ◽  
Vol 65 (3) ◽  
pp. 171-184
Author(s):  
Jennifer Rivas
Keyword(s):  
Primary Care ◽  
Advanced Access

scholarly journals Advanced Access scheduling in general practice and use of primary care: a Danish population-based matched cohort study

BJGP Open ◽  
2020 ◽  
Vol 4 (5) ◽  
pp. bjgpopen20X101091
Author(s):  
Maria Bang ◽  
Henrik Schou Pedersen ◽  
Bodil Hammer Bech ◽  
Claus Høstrup Vestergaard ◽  
Jannik Falhof ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Cohort Study ◽  
Population Based ◽  
Matched Cohort ◽  
Face To Face ◽  
Matched Cohort Study ◽  
Adjusted Incidence Rate ◽  
Advanced Access ◽  
The Impact

BackgroundAdvanced access scheduling (AAS) allows patients to receive care from their GP at the time chosen by the patient. AAS has shown to increase the accessibility to general practice, but little is known about how AAS implementation affects the use of in-hours and out-of-hours (OOH) services.AimTo describe the impact of AAS on the use of in-hours and OOH services in primary care.Design & settingA population-based matched cohort study using Danish register data.MethodA total of 161 901 patients listed in 33 general practices with AAS were matched with 287 837 reference patients listed in 66 reference practices without AAS. Outcomes of interest were use of daytime face-to-face consultations, and use of OOH face-to-face and phone consultations in a 2-year period preceding and following AAS implementation.ResultsNo significant differences were seen between AAS practices and reference practices. During the year following AAS implementation, the number of daytime face-to-face consultations was 3% (adjusted incidence rate ratio [aIRR] = 1.03; 95% confidence interval [CI] = 0.99 to 1.07) higher in the AAS practices compared with the number in the reference practices. Patients listed with an AAS practice had 2% (aIRR = 0.98; 95% CI = 0.92 to 1.04) fewer OOH phone consultations and 6% (aIRR = 0.94; 95% CI = 0.86 to 1.02) fewer OOH face-to-face consultations compared with patients listed with a reference practice.ConclusionThis study showed no significant differences following AAS implementation. However, a trend was seen towards slightly higher use of daytime primary care and lower use of OOH primary care.

scholarly journals P084: Waiting makes me sick: is it time for formal triage in primary care?

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S106-S106
Author(s):  
J. MacKay ◽  
P.R. Atkinson ◽  
M. Howlett ◽  
E. Palmer ◽  
J. Fraser ◽  
...  
Keyword(s):  
Primary Care ◽  
Wait Time ◽  
Patient Survey ◽  
Wait Times ◽  
Cross Sectional ◽  
Triage System ◽  
Care Appointment ◽  
Open Scheduling ◽  
Primary Care Practices ◽  
Advanced Access

Introduction: Patient morbidity and mortality are influenced by delay in access to care and lack of continuity of care. Patients frequently present to the emergency department (ED) for care despite being registered with a primary care (PC) provider. Advanced access is an open scheduling system promoted by the College of Family Physicians of Canada that triages primary care (PC) patients to be seen within 24 hours, reducing care delay. We wished to determine the prevalence of formal triage systems in PC appointment allocation. Methods: We performed linked cross sectional surveys to quantify the number of ambulatory patients presenting to a tertiary urban ED (with an annual census of 56,000 visits) who felt unable to access primary care. PC practices were also surveyed to assess use of formal triage methods and measure access using the metric of time to third next available appointment. Descriptive statistics were calculated. Results: In the patient survey, 381 of 580 patients consented to participate. Of those, 324 patients reported reasons for their ED visit. Perception that wait time for PC was “too long” was reported in 73/324 (23%); 86% reported wait times of greater than 48 hours. The PC practice response rate was 63.8% (46/ 72). The mean time to third next available appointment was 7.7 (95% CI 4.9-10.5) days (median 5 days, range 0-50 days). No PC practice reported utilizing a formal triage system when booking appointments. Conclusion: No primary care practices in the surveyed region used a formal triage system to allocate appointments, despite a range of wait times that extended up to 50 days. The safety of primary care appointment allocation may be improved with introduction of a formal triage system, especially if overall wait times cannot be reduced.

scholarly journals After COVID-19: Improving the Patient's Outpatient Appointment Experience

2021 ◽  
Vol 8 ◽  
pp. 237437352110393
Author(s):  
Helen Y. Gant-Farley ◽  
Miriam K. Ross ◽  
Ronald P. Hudak
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Primary Care Providers ◽  
Care Physician ◽  
Care Providers ◽  
Missed Appointments ◽  
Outpatient Appointment ◽  
Study Results ◽  
Outpatient Appointments ◽  
Advanced Access

As the COVID-19 pandemic diminishes, it is expected that patients will seek more outpatient appointments resulting in adverse patient and clinic experiences if there is a corresponding increase in missed appointments. This study's purpose was to determine if there was an association between advanced access scheduling, also known as open access or same day scheduling, and missed appointment rates for patients scheduled with preferred primary care physicians vis-a-vis nonpreferred primary care physicians. Patients prescheduled with primary care providers and over the age of 18 years were included in the study, which totaled 4815 visits. Study results demonstrated a statistically significant mean proportion difference between the national no-show rate and the study's no-show rate as well as a significant association between physician type and visit status. The results suggested the potential for improving the patient experience with advanced access scheduling if patients are scheduled with their preferred primary care physician. This study may promote positive patient experiences by providing patients and clinicians with an understanding of the significance surrounding advanced access scheduling thus decreasing missed appointments.

scholarly journals Interprofessional advanced access – a quality improvement protocol for expanding access to primary care services

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Isabelle Gaboury ◽  
Mylaine Breton ◽  
Kathy Perreault ◽  
François Bordeleau ◽  
Sarah Descôteaux ◽  
...  
Keyword(s):  
Primary Care ◽  
Quality Improvement ◽  
Social Services ◽  
Nurse Practitioners ◽  
Practice Facilitation ◽  
Care Services ◽  
Primary Care Services ◽  
Primary Care Teams ◽  
Access To Primary Care ◽  
Advanced Access

Abstract Background The Advanced Access (AA) Model has shown considerable success in improving timely access for patients in primary care settings. As a result, a majority of family physicians have implemented AA in their organizations over the last decade. However, despite its widespread use, few professionals other than physicians and nurse practitioners have implemented the model. Among those who have integrated it to their practice, a wide variation in the level of implementation is observed, suggesting a need to support primary care teams in continuous improvement with AA implementation. This quality improvement research project aims to document and measure the processes and effects of practice facilitation, to implement and improve AA within interprofessional teams. Methods Five primary care teams at various levels of organizational AA implementation will take part in a quality improvement process. These teams will be followed independently over PDSA (Plan-Do-Study-Act) cycles for 18 months. Each team is responsible for setting their own objectives for improvement with respect to AA. The evaluation process consists of a mixed-methods plan, including semi-structured interviews with key members of the clinical and management teams, patient experience survey and AA-related metrics monitored from Electronic Medical Records over time. Discussion Most theories on organizational change indicate that practice facilitation should enable involvement of stakeholders in the process of change and enable improved interprofessional collaboration through a team-based approach. Improving access to primary care services is one of the top priorities of the Quebec’s ministry of health and social services. This study will identify key barriers to quality improvement initiatives within primary care and help to develop successful strategies to help teams improve and broaden implementation of AA to other primary care professionals.

Advanced-Access Scheduling in Primary Care--Reply

JAMA ◽  
2003 ◽  
Vol 290 (3) ◽  
pp. 333-b-334
Author(s):  
T. Bodenheimer
Keyword(s):  
Primary Care ◽  
Advanced Access

Advanced-Access Scheduling in Primary Care--Reply

JAMA ◽  
2003 ◽  
Vol 290 (3) ◽  
pp. 333-a-333 ◽  
Author(s):  
M. Murray
Keyword(s):  
Primary Care ◽  
Advanced Access

Advanced-Access Scheduling in Primary Care

JAMA ◽  
2003 ◽  
Vol 290 (3) ◽  
pp. 333-333 ◽  
Author(s):  
D. Siegel
Keyword(s):  
Primary Care ◽  
Advanced Access
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