Delivery System Design Tools
General Tools
IHI Conference Presentation
Information Gathering Tools
Medication Reconciliation
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Delivery System Design Tools
This service agreement aims to get into the work of access and flow between primary and secondary care. It is a tried and effective approach, but does require work.
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The Group Visit Starter Kit will provide you with step-by-step instructions on how to begin running group visits with your patients; developed by Improving Chronic Illness Care (Seattle, Washington, USA)
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General Tools
This tool helps individual physician practices measure safety and quality processes; developed by the Medical Group Management Association (Englewood, Colorado, USA) in collaboration with Health Research and Educational Trust and the Institute for Safe Medication Practices
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This paper describes key issues for physician practices to consider regarding patient panel size and presents strategies for understanding how panel size drives demand, how to quantify panel size, the importance of panel equity, applying simple panel adjustments, and more.
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This tool may be used to assess how your clinical microsystem compares to the 10 key "success" characteristics of high-performing clinical microsystems; developed by Dartmouth-Hitchcock Medical Center (Lebanon, New Hampshire, USA)
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IHI Conference Presentation
Iowa Health System (Des Moines, Iowa, USA) presented its tests of change at the IMPACT Learning Session which focused on improving the six quality dimensions from the Institute of Medicine's Report Crossing the Quality Chasm.
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Information Gathering Tools
A "Minutes Behind" graph is a very helpful way to show graphically the effect of providers starting late/staying late, starting late/catching up, and starting on time/getting late.
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Use this script when patients are late for an appointment to keep access to care under control.
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Scripts for use by front desk/receptionist staff about what to say to patients when they call for an appointment.
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This is Chapter 9 on Group Visits from the book, What Works: Effective Tools and Case Studies to Improve Clinical Office Practices by Suzanne Houck. Included are visit formats, sample handouts, space formats, and coding for group visits.
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The Institute for Healthcare Improvement (Boston, Massachusetts, USA) developed this spreadsheet to help tally the results from the Today's Office Visit Survey Card.
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A glossary for common terminology for improving access to care.
Updated: August 6, 2004
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This four-question survey card is used to retrieve quick feedback to determine patient satisfaction for today's office visit.
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The True Demand Formula is an easy-to-use tool to determine the true patient demand, both internal and external, in your office practice; developed by Tantau & Associates (Chicago Park, California, USA)
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Standardizing supplies and inventory leads to decreased re-work, high predictability of needed supplies being present, and fewer interruptions to the flow of patient care.
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One way to understand inefficient processes and interrupted flow is to identify waits and delays in the process.
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Standardizing the process for rooming patients by diagnosis increases efficiency and decreases variation.
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Once the team determines where the waits and delays are occurring, it can take steps to minimize the constraint or, in some cases, eliminate it. One key measure of office efficiency is the patient cycle time.
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"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.
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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.
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Medication Reconciliation
To promote patient safety and reduce the growing incidence of medication errors in the office setting, this patient medication list was created for patients and their families to carry with them to medical appointments; developed by the Massachusetts Coalition for the Prevention of Medical Errors (Burlington, Massachusetts, USA) in collaboration with the Massachusetts Medical Society
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