Patient-centred access to appointments: What’s not to like?

2012-05-31 Access GB

I’ll be first to admit I’m no expert on advanced access, a key piece of Saskatchewan’s Clinical Practice Redesign (CPR) initiative. I got a crash course recently, when Catherine Tantau was in Saskatoon meeting with CPR coaches from around the province. Tantau is an internationally recognized authority on access, efficiency, and flow in health care; she played a lead role in developing the advanced access model.

I cornered Catherine for a short interview, after the workshop, but before she headed off for a yoga class on Broadway Ave. Here’s her elevator explanation of advanced access: the practice arranges its services so patients can get an appointment with a physician or provider of their choice, at a time that’s convenient for them – this might even mean they get in the same day. Talk about patient-centred care!

Catherine said a number of things that really stood out for me:

  • Providers can deliver the best clinical care, technically speaking, but if a patient can’t get in to see his or her provider at a time that works for them, that care is ineffective – essentially it doesn’t exist.
  • The way our health system has historically defined urgent is at odds with the real lives of patients. In this short clip, Catherine gives some examples:

  • Providers want to see their patients when they want to be seen. Their frustration in not being able to do that is often the proverbial straw that brings them around to trying advanced access.
  • Catherine says advanced access appears to be working particularly well in rural Saskatchewan. Basically, doctors reduce waits for appointments > patients get in to see them > continuity of care improves > fewer patients resort to showing up in emergency. Wins all around.
  • Catherine’s face positively lit up when she related what doctors have told her, about why they like advanced access. Spoiler alert: doctors really do like their patients.

Patients dig it. Doctors do too. Advanced access is all about giving the people what they want.

I can’t see any downside in making this the new normal. What do you think?

PS – we’ll be posting the full interview(s) with Catherine on our YouTube channel. Stay tuned.

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2 Responses to “Patient-centred access to appointments: What’s not to like?”

  1. Heather Thiessen
    May 31, 2012 at 8:43 pm #

    Hi Greg…interesting process and the fact that physicians like it makes it even more appealing. I have often thought how nice it would be for me to book appointment to specialist when it was best for me as well. The fact that patients making appointments might reduce a lot of missed or forgotten appointments on the side of patients. I guess my only concern is that is you are to see a specialist how would they get all the pre medical information that a family physician or other specialist may send to the doctor the patient needs to see. I guess with an implementation of more standard electronic records system may make this who concept work well.

    As I am a frequent flyer patient in the health region, I often sit and ponder ways to make things easier for patents and seeing this makes me happy.

    Thanks for the great article.

    • Greg Basky
      Greg Basky
      June 1, 2012 at 11:42 am #

      Thanks for the note, Heather. The SK health care system is in fact working to shorten the wait to see specialists down to 7 days — this is one of the targets set out in the new provincial health plan. One of the main reasons the target is 7 days, not same day, is because — as you note — we don’t yet have the supporting IT in place. That 7-day gap is to ensure that specialists have all the information they need from family doctors to ensure your time with the specialist is of maximum value to you the customer / patient. According to Catherine Tantau though, the advanced access concept is every bit as applicable and relevant to specialists and diagnostics as it to primary care.

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