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Sustained improvement for specialty clinic access.
Mary Therese Hankinson1, Donna Faraone, Marvin Blumenfrucht
1Department of Veterans Affairs New Jersey Health Care System, East Orange, USA. mary.hankinson@med.va.gov
Joint Commission Journal on Quality and Patient Safety
|April 19, 2006
Summary
Veterans Affairs New Jersey Health Care System improved urology clinic access by implementing advanced clinic access (ACA) strategies and a facility communication model. This resulted in significantly reduced appointment wait times, exceeding national averages.
Area of Science:
- Healthcare Management
- Clinical Operations Improvement
- Patient Access to Care
Background:
- Veterans Affairs New Jersey Health Care System (VA NJHCS) implemented Advanced Clinic Access (ACA) strategies and a facility communication model.
- The initiative aimed to enhance healthcare access across two medical centers and a community-based outpatient clinic.
- Key components included integrating a performance improvement (PI) structure, leveraging technology, and fostering staff participation.
Purpose of the Study:
- To evaluate the effectiveness of ACA strategies and a facility communication model in improving access to specialty care.
- To assess the impact on appointment wait times, specifically for urology clinics.
- To compare VA NJHCS's improvements against national Veterans Health Administration (VHA) averages.
Main Methods:
- VA NJHCS participated in a Veterans Integrated Service Network (VISN 3) collaborative from June 2001 to January 2002.
- Implemented ACA strategies: reduced appointment types, decreased demand, established primary care service agreements, and standardized documentation.
- Focused on enabling specialty clinics to schedule appointments within 30 days.
Main Results:
- Average wait time for urology clinic appointments at VA NJHCS decreased by 85.9%, significantly outperforming the VHA national average reduction of 26.2%.
- By June 2005, VA NJHCS achieved an average wait time of 14.2 days, which was 63.4% better than the VHA average of 38.8 days.
- The facility model contributed to a waiting time reduction exceeding the VHA national average for urology clinics.
Conclusions:
- The combined use of collaborative model, ACA strategies, and a facility model effectively reduced urology clinic appointment wait times at VA NJHCS.
- The facility model's unique contribution led to superior wait time reductions compared to national VHA benchmarks.
- These findings demonstrate a successful approach to improving patient access in a healthcare system.