Improvement Insights: Access in Primary Care
The Improvement Insight series highlights quality improvement projects within Southcentral Foundation’s Nuka System of Care. Each blog offers a detailed look at how SCF’s customer and community owned approach, data-driven strategies, and collaborative teams work together to initiate innovative solutions for current challenges.
Southcentral Foundation continually works to make care as accessible as possible for customer-owners. One of SCF’s Operational Principles is “Access is optimized and waiting times are limited,” reflecting SCF’s commitment to access to care. SCF has offered customer-owners same-day access to their primary care teams for years, but this does require the customer-owner to call in and schedule an appointment, which might also require a callback and an appointment scheduled late in the day. Some customer-owners prefer a more convenient process, and so SCFis working to implement Access Now, which makes walk-in appointments available for customer-owners during business hours.
Access Now is a pilot of a program that will allow a customer-owner to walk in to any of SCF’s nine primary care clinics in the Yagheli Shesh Qenq’a Anchorage Native Primary Care Center and request an appointment with an identified Access Now provider. SCF piloted this program through two Plan-Do-Study-Act initiatives over 14 weeks. SCF tracked a variety of both quantitative and qualitative data, including number of Access Now visits, number of Access Now appointments that were not kept, and customer-owner and employee satisfaction with the program.
Feedback from customer-owners was overwhelmingly positive, with surveys showing an average rating of 3.8 for visit satisfaction on a 4-point scale (where 3 is “Agree” and 4 is “Strongly Agree”). Feedback from employees was also positive, with the statement “I would like to see the Access Now process implemented at Anchorage Primary Care” scoring 3.3 on the same 4-point scale.
One provider stated the following about the program:
“[Access Now] has expanded access to same-day acute care for our customer-owner population, allowing me to address immediate concerns while also facilitating reconnection with their primary care teams.
The most significant benefit, however, has been for customer-owners who face barriers to attending pre-scheduled appointments. In contrast to my previous role as a team coverage provider, I’ve encountered a notably higher proportion of individuals dealing with housing instability, transportation challenges, mental health conditions, or substance use issues – factors that often impede their ability to engage with traditional scheduling models. Chart reviews frequently reveal that many of these individuals have had little to no prior contact with their designated primary care provider.
During Access Now visits, I’ve been able to address acute needs while also initiating or updating preventive care measures such as cervical cancer screenings, immunizations, and other essential services that might otherwise be overlooked. Although these visits often extend beyond the standard 30-minute timeframe, the flexibility of a not entirely booked schedule has enabled me to deliver more comprehensive care.
In summary, the Access Now pilot has created a valuable opportunity to better serve customer-owners whose social circumstances limit their access to care – meeting both their immediate and primary care needs in a more responsive and equitable manner.”
For more information on Access Now, or any other aspect of SCF’s Nuka System of Care, feel free to contact the SCF Learning Institute.
