ACCESS
• Time: 20 minutes
• Audience: 1st – 3rd year residents
• Objective(s): Understand how patient access for different care
needs (same-day, acute, preventative, chronic care follow up,
etc) can be tracked over time, and how to use this data to
innovate systems to meet these needs
Soraya Azari, MD
Education Team
UCSF Division of General Internal Medicine at Zuckerberg San Francisco General Hospital
The UCSF Double Helix Curriculum:
Transformation of High-Performing Primary Care in Education
Facilitator Guide
How to Measure and
Interpret Access
Adapted from the Center for Excellence in Primary Care
Soraya Azari, MD
Education Team
UCSF Division of General Internal Medicine at Zuckerberg San Francisco General Hospital
The UCSF Double Helix Curriculum:
Transformation of High-Performing Primary Care in Education
ACCESS
Metric
% Same Day
Appointments
Definition
ACCESS
What to Look For
# of appointments that
were scheduled the same Meeting same day ratio
day / # scheduled
targets
appointments
# open slots / #
% open capacity
appointments available
There are enough
appointments in the future
to continue to book into
3rd Next
Available
Should be =< 1
# days until 3rd open
appointment
Soraya Azari, MD
Education Team
UCSF Division of General Internal Medicine at Zuckerberg San Francisco General Hospital
The UCSF Double Helix Curriculum:
Transformation of High-Performing Primary Care in Education
Key Measures
Clinic Schedule
Appointment Scheduled
1:00
PM HUDDLE
1:20
TODAY
1:40
2 weeks ago
2:00
2 weeks ago
2:20
1 month ago
2:40
TODAY
3:00
Yesterday
Soraya Azari, MD
Education Team
UCSF Division of General Internal Medicine at Zuckerberg San Francisco General Hospital
ACCESS
The UCSF Double Helix Curriculum:
Transformation of High-Performing Primary Care in Education
Same Day Appointments
ACCESS
• Identifies if the next 2 weeks/month/etc. has needed
availability
• Tracking this data helps to forecast scheduling and balancing
of time off requests.
• Data shows the total number of slots a provider has during a
specified time period, how many are filled and how many are
available.
Soraya Azari, MD
Education Team
UCSF Division of General Internal Medicine at Zuckerberg San Francisco General Hospital
The UCSF Double Helix Curriculum:
Transformation of High-Performing Primary Care in Education
Future Open Capacity
ACCESS
Week
This week
Next Week
3 Weeks
4 Weeks
# Open
2
10
25
45
50
50
50
Total
50
Appointments
Available
Soraya Azari, MD
Education Team
UCSF Division of General Internal Medicine at Zuckerberg San Francisco General Hospital
The UCSF Double Helix Curriculum:
Transformation of High-Performing Primary Care in Education
Future Open Capacity
ACCESS
Week
This week
Next Week
3 Weeks
4 Weeks
# Open
2
10
25
45
50
50
50
Total
50
Appointments
Available
Future Open
Capacity:
82
200
= 41%
Soraya Azari, MD
Education Team
UCSF Division of General Internal Medicine at Zuckerberg San Francisco General Hospital
The UCSF Double Helix Curriculum:
Transformation of High-Performing Primary Care in Education
Future Open Capacity
ACCESS
• Meet with schedulers. Are same day appt declining and being
used for pre-books/follow ups?
• Lengthen return intervals
• Is face to face follow up necessary or can it be done over the
phone or by another team member?
• Look at demand—do you need to increase or decrease same
day ratio?
Soraya Azari, MD
Education Team
UCSF Division of General Internal Medicine at Zuckerberg San Francisco General Hospital
The UCSF Double Helix Curriculum:
Transformation of High-Performing Primary Care in Education
Strategies to Improve
ACCESS
“How long does our patient need to wait for an appointment?”
Soraya Azari, MD
Education Team
UCSF Division of General Internal Medicine at Zuckerberg San Francisco General Hospital
The UCSF Double Helix Curriculum:
Transformation of High-Performing Primary Care in Education
Third Next Available
Appointment
Day of the Week Mon Tues Wed Thur
X
Open/Scheduled
Appointments
3rd Next Available
Measure
ACCESS
Fri
Sat
X
X
X
X
X
X
X
X
X
X
X
X
X
1
2
3
4
5
0
Sun Mon Tues
6
Soraya Azari, MD
Education Team
UCSF Division of General Internal Medicine at Zuckerberg San Francisco General Hospital
7
8
The UCSF Double Helix Curriculum:
Transformation of High-Performing Primary Care in Education
Third Next Available
Appointment
ACCESS
Day of the Week Mon Tues Wed Thur
Fri
Sat
X
Open/Scheduled
Appointments
3rd Next Available
Measure
Sun Mon Tues
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
0
1
2
3
4
5
6
Soraya Azari, MD
Education Team
UCSF Division of General Internal Medicine at Zuckerberg San Francisco General Hospital
7
8
The UCSF Double Helix Curriculum:
Transformation of High-Performing Primary Care in Education
Third Next Available
Appointment
Day of the Week Mon Tues Wed Thur
X
Open/Scheduled
Appointments
3rd Next Available
Measure
ACCESS
Fri
Sat
X
X
X
X
X
X
X
X
X
X
X
X
X
1
2
3
4
5
0
Sun Mon Tues
6
Soraya Azari, MD
Education Team
UCSF Division of General Internal Medicine at Zuckerberg San Francisco General Hospital
7
8
The UCSF Double Helix Curriculum:
Transformation of High-Performing Primary Care in Education
Third Next Available
Appointment
ACCESS
• Evaluate daily use of appt schedules with staff. Are same day
appts slots being used appropriately?
• Evaluate provider availability per demand needs (ie days
scheduled)
• Contingency plans for vacation, leave, illness
Soraya Azari, MD
Education Team
UCSF Division of General Internal Medicine at Zuckerberg San Francisco General Hospital
The UCSF Double Helix Curriculum:
Transformation of High-Performing Primary Care in Education
Strategies to Improve
Simple Way
• Create a “drop dead”
date
• Block appointments
for same/next day
access
ACCESS
Alternative
Way
• Bring in additional
supply in order to
start meeting pent
up demand
Soraya Azari, MD
Education Team
UCSF Division of General Internal Medicine at Zuckerberg San Francisco General Hospital
The UCSF Double Helix Curriculum:
Transformation of High-Performing Primary Care in Education
Creating Capacity Today
Understand your data!
# of people who call today
for an appointment
# of appointments per day
Soraya Azari, MD
Education Team
UCSF Division of General Internal Medicine at Zuckerberg San Francisco General Hospital
ACCESS
The UCSF Double Helix Curriculum:
Transformation of High-Performing Primary Care in Education
Deciding on How Much
Capacity to Reserve
Soraya Azari, MD
Education Team
UCSF Division of General Internal Medicine at Zuckerberg San Francisco General Hospital
ACCESS
The UCSF Double Helix Curriculum:
Transformation of High-Performing Primary Care in Education
Communicating to Patients
ACCESS
Role
Training
All Staff
• Reason for this work in this clinic
• Overview of the new model
• How patients will be informed
Front Desk/
Schedulers
• New scheduling guidelines
• Communicating with patients about the changes (scripts)
• Managing requests for appointments when there are no appointments
left
Clinical Support
Staff
• New scheduling guidelines
• Tracking patients who do not need follow up appointments
• Communicating with patients about the changes
• Managing requests for appointments when full
PCPs
• New scheduling guidelines
• Deciding who needs a follow up appointment
• Communicating with patients about the schedule
• Understanding scheduling data
Soraya Azari, MD
Education Team
UCSF Division of General Internal Medicine at Zuckerberg San Francisco General Hospital
The UCSF Double Helix Curriculum:
Transformation of High-Performing Primary Care in Education
Communicating to Staff
ACCESS
• Bring the point at which supply and demand is balanced closer
to today
• Use the schedule for scheduling – not for tracking patients
• Communicate, communicate, communicate – both to patients
and to staff
• Follow the data
Soraya Azari, MD
Education Team
UCSF Division of General Internal Medicine at Zuckerberg San Francisco General Hospital
The UCSF Double Helix Curriculum:
Transformation of High-Performing Primary Care in Education
Key Principles
Evaluation
Soraya Azari, MD
Education Team
UCSF Division of General Internal Medicine at Zuckerberg San Francisco General Hospital
The UCSF Double Helix Curriculum:
Transformation of High-Performing Primary Care in Education
ACCESS