Table 2.

Access Management Framework Used for the Pre-Panel Survey

I. Patient Populations, Service and Practice Contexts

A. Patient population characteristics requiring special access management attention (e.g., difficulty getting to clinic; difficulty using the phone or computer)

B. Primary care practice site characteristics requiring special access management attention (e.g., has a rapidly expanding patient population, high demand for walk-in care)

C. Specialty care issues that impact primary care (e.g., availability of mental health specialists, availability of specialist care for common problems or for urgent problems)

II. Evaluating and Managing Supply and Demand in Primary Care

A. Primary care practice site level supply and demand context evaluation: Parameters that should be routinely measured or evaluated at appropriate intervals, such as annually

•Demand parameters (e.g. total number of patients visiting the primary care site during the past year; availability of equipment for enabling access such as telephone or mobile technology)

•Supply parameters (e.g., total number of primary care providers versus total number of patients visiting in the past year; primary care provider and staff morale)

B. Management approaches to address overall supply and demand mismatches: Access managers routinely use or can demonstrate systematic approaches to mismatch (e.g., building capacity ahead of demand; ensuring adequate availability of contingency staffing)

C.Evaluating supply and demand among individual providers and their panels (e.g., proportion of all slots for a given clinic day that remain un-booked at the beginning of that clinic day; match provider hours committed to clinical primary care to the clinic sessions actually booked over the past month)

D. Managing supply and demand among individual providers and their panels within a primary care practice site (e.g. team RNs prospectively manage demand by leading care coordination for panels; patients can book visits online)

E. Evaluating the availability of alternatives to face-to-face visits at a primary care practice site (e.g., weekend, early morning or after hours face to face visits; group visits for common chronic conditions)

F. General management strategies for optimizing the quality of site level patient access (e.g. engage patient representatives in strategic planning and improvement projects; ensure inter-professional leader communication and input into decisions)

III. Promoting Successful Group Practice Management: Promising organizational features for promoting access management success (e.g., a clearly identified group practice management structure; ongoing multilevel training of executive, middle-management, front-line staff/clinicians)

IV. Managing Demand by Identifying and Managing Complex or Challenging Patients (e.g., identify the proportions of complex patients in each panel within a site; have mechanisms for engagement of inter-professional input to support primary care provider management of challenging patients, such as disruptive, combative, or severely non-adherent individuals)

V. Evaluation of Access Management Short, Medium and Long-Term Outcomes (e.g., overall time patients must wait for a requested face to face visit, quality of patient experience of access)