1. Access to Primary Care Services Incremental Improvements Presented by: Cathy Simpson, DMC South East Ottawa CHC

2. Introduction At South East Ottawa CHC we are using scheduler data to: – Calculate our provider capacity availability – Calculate our provider capacity used – Determine if capacity available and capacity used are balanced – Optimize delivery model based on results – Realize the benefits of maximum utilization of resources

3. Existing reporting Currently the only reports available to your DMC to determine capacity used is your Hummingbird Report, ‘Scheduled Appointments by Provider per day”

4. Existing reporting (con’t) This report – Is difficult to verify accuracy. The Associated Summary Report: – Does not consider supply capacity in calculating the average which is the “# of hours (minutes) and appointments actually available in a provider practice throughout the day” Hummingbird Report uses #appointments / #days worked

5. Existing Data available in Scheduler Through Scheduler data we can: – Accurately calculate capacity available through the use of preprogrammed scheduler templates – Accurately determine capacity used – Determine if capacity used was for Advanced Access or Pre-booked appointment through the use of appointment types – Accurately calculate no show rates

6. Con’t Accurately calculate Clinical FTE through the use of preprogrammed templates A clinical FTE factors out non-visit work (admin time) CURRENT PANELExample AThe practice panel: The number of unique patients who have seen any provider (MD, NP or PA) in the practice in the last 12 or 18 months 6000 BFull-time-equivalent (FTE) providers 4.00 CFTE providers devoted to nonvisit work 1.00 DFTE clinical providers (B - C) 3.00 EThe "target" panel for each FTE clinical provider (A ÷ D) 2000

7. Ease of Implementation The scheduler is regularly used with preprogrammed templates throughout the CHC sector. The sector has been very diligent in correctly recording no show clients Scheduler data can be immediately verified (not dependent upon data extraction)

8. Our approach at SEOCHC In an effort to improve access to Primary Care Services we have presented to the e-clinical team the following: Time available in minutes = available capacity Time booked in minutes = clients booked into scheduler Time Used in minutes = Time booked less no shows Not used in minutes = available less time used

9. Sample Report

10. Our approach (con’t) We also report: The number of unique clients seen in the period and total number of appointments. The average length of appointment: – The average appointment length is an important variable that can be increased or decreased to optimize care delivery models, i.e.) increase available capacity

11. Our approach (con’t) Provider visits per day–this metric unlike the Hummingbird report only uses the Clinical FTE capacity, time available to see clients * note attached

12. Our approach (con’t) We also provide number of new clients which is another variable that can be increased or decreased to optimize care delivery. i.e.) if available capacity exceeds used capacity, we will be able to accommodate new clients New to CentreSeen by an NP or MD Female17067 Male11464 Total [1] 284131 [1]

13. Our approach (con’t) The final analysis is to determine if available and used capacities are balanced. If there is any (+) unused time, availability exceeds used. If there is any (–) unused time, used exceeds availability (ie., double bookings or seeing clients after scheduled day end

14. Conclusion At SEOCHC if availability exceeds used capacity we calculate that in a ‘potential to see more clients’ metric. We are currently piloting a two exam room service delivery method based on our conclusions: Note attached

15. Conclusion (con’t) We have presented these reports for 4 consecutive quarters. We have seen improvements every quarter.

16. Actual data demonstrating improvements

17. Thank you to: Cathy Collette, I worked with Cathy on the Centretown Advanced Access pilot project where I wrote some of these reports. Leslie McDiarmid, Executive Director of South East Ottawa for guidance at Quarterly report time. The entire e-clinical team at South East Ottawa