1. McGregor Clinic, Inc. ….giving voice to patient choice Providing primary care medically needy and underserved population living with HIV/AIDS Established in 1999 Fort Myers, Fl 33901

2. Increase Client Access to Care McGregor Clinic provides medical and social services to over 800 clients. Results of client surveys noted that clients would like same-day appointments for sick visits and a decrease in wait time for scheduled appointments.

3. Plan, Do, Study, Act Establish Clinical Teams One Practitioner, Two Nurses Circulating Nurse to be available in Clinic as needed Triage Nurses for telephone triage, medication checks and refills

4. Plan, Do, Study, Act Each nurse works with clients scheduled at half hour increments. Appointments divided into top of the hour and on the half hour appointments Each practitioner has one appointment opening in the morning and one in the afternoon for same-day sick visits. Circulating nurse works with practitioner for sick visits

5. Plan, Do, Study, Act The check-in time for each scheduled appointment and entrance into exam room was noted. The circulating nurse worked with the triage nurses to facilitate same-day appointments for clients determined to be eligible for clinic visits versus referral to ER or urgent care services. Sick visits were limited to 10 minute appointments to address the chief complaint

6. Evaluation The development of a clinical team kept practitioners on schedule while allowing for same day appointments. This schedule has been in place for two weeks and wait time for scheduled appointments has decreased significantly. Clients have been called into clinic within 10 minutes of check-in. This schedule protocol will become policy.