AHS Department of Medicine :: Calgary, Alberta :: Medical Access to Service (MAS) :: Our Purpose

Medical Access to Service (MAS) - Our Purpose

The purpose of this project is to broadly engage participants in the health system to collectively improve patient access to primary care and specialized medical services and to improve service integration and communication between medical specialists, primary care physicians and the healthcare team. More specifically the following solutions will be implemented:

1. Creation and/or standardization of Central Intake Systems across most specialized medical services.

Central Intake to be developed piloted & implemented.
Where central intake already in place, focus on standardizing process across all divisions and development of WCWL prioritization tools

• Cardiology Urgent Assessment Clinic (link to Cardiac Access proposal), April 2008
• Endocrinology , June 2008
• General Internal Medicine, November 2007
• Hematology, April 2008
• Respirology, June 2008
• Gastroenterology (in place prior to project)
• Nephrology (in place)
• Geriatrics (in place)
• Rheumatology (in place)

The key changes to process as a result of the Medical Access to Service project work are:

• The introduction of a single standard referral form for all involved specialties. This has replaced a number of existing separate forms, and aims to increase the ease of making referrals for family physicians, while ensuring that the specialties get the minimum information that they require to triage the patient referral.
  
  
• Increased flexibility in that the format of the referral submission is not important. The key is to ensure all listed, required information for the relevant specialty is included and that the patient’s requirements for care are specified. A completed form, an EMR generated form or other formats, will therefore be accepted by the specialties.
  
  
• The introduction of Central Intake Clinics for a number of specialties that have the goal of streamlining the receipt of referral and triage processes, and getting patients to the right specialist in the right timeframe.
  
  
• The introduction of standard processes and target times for these Central Intakes, including things such as acknowledging receipt of referrals within 2 days, triaging referrals within 7 days of receipt, and clarifying responsibility for arranging tests for triage and consultation.
  
  
• Improvements in communication strategies: Contact to inform the patient about a specialty consultation booking is the responsibility of the specialty clinic. The referring physician will also be informed of the booking
  
  

2. Implementation of two AIM (Access Improvement Measure) collaboratives to improve access and efficiency in both primary care and specialized medical ambulatory care settings. The first collaborative started Fall 2007, the second collaborative will start Fall 2008.

3.Development and piloting of a service model for patients with chronic, complex needs. This is a highly supported clinic based approach to enhance access to specialized medical services for patients with a history of frequent inpatient admissions, and complex chronic needs. The PLC-based clinic started to see patients in March 2008.

4. The Referral and Access Management component to facilitate communication and status tracking for the patient and referral source (often primary care), manage referral standards, manage inbound electronic referrals and track end to end process metrics (e.g. time from receipt of referral to first appointment) to facilitate workflow optimization and reporting to provincial registries.

The Referral and Access Management Project is the piece of the ambulatory architecture that specifically supports the exchange of information between pieces of the care continuum (i.e. the referral process). Several clinical CHR services are working on these requirements and process implementation including Medical Access to Services, Mental Health, Bone & Joint Health and Neurosciences. Medical Access to Services is facilitating collaboration between these groups to share best practices and identify areas of commonality.

Project Evaluation

Criteria to Measure Success:

• Improved quality of health service delivery
• Improved access to specialized medical services
  • Appropriateness of service delivery
  • Improved safety
• Improved service integration (system wide impact)
• Improved efficiency in service delivery (cost savings)
• Appropriate use of human resources
• Knowledge translation