35 Questions to Improve Your Health Care Access Process

Jeff Doleweerd • March 11, 2017

When trying to improve your health care access process, you’re best to first understand your current process. The most effective way to understand is to go find out. This means watching the process as it happens and gathering the facts.


After 10+ years of studying health care access processes, we have learned what to look for. Use these questions when investigating your access process to set a strong foundation for improvement work.


Patient Group


1) Which client/patient group’s access process are you investigating?


Referral Reception


2) What documentation did the patient receive when they were referred?


3) How do you find out about new clients/patients (phone, voicemail, fax, visit, electronic, etc.)?


4) Where do referrals come from?


5) Who are your most trusted referrers?


6) What volumes come from each referral source?


7) By what method do referrals arrive, for each referral source?


8) How are your referrals prioritized?


9) Where do you store received referrals?


10) Do you receive and process referrals on behalf of other agencies? If so:

  • How many referral destinations do you have?
  • Do you process referrals differently depending on the agency they are for?
  • How long does it take to process a referral for another agency?
  • Do you contact the client directly, or does the other agency?
  • What types of assessments, if any, are done?


Referral Forms and Ancillary Documentation


11) What form(s) are used for received referrals?


12) What information does the form show/collect?


13) How often is the form filled out incorrectly?


14) What ancillary documentation do you require from the referrer? Does it get sent consistently?


15) If the referral form or ancillary documentation is incomplete, how long is spent remedying the situation?


Patient First Contact


16) How do you first contact the patient (phone, voicemail, fax, visit, etc.)?


17) Who performs the first contact?


18) How long does the first contact last?


19) What information is gathered at the first contact?


20) What information & documentation is provided to the patient on the first contact?


21) How long was the wait since the referral (min/max/average)?


22) What is the referral backlog on average? (i.e., How many people are waiting to be contacted)?


Registration and Scheduling


23) After you make first contact with the patient, how long is the wait for their first appointment (min/max/average)?


24) What electronic system, or non-electronic method, is used to schedule patients?


25) How long does the scheduling and booking process take?


26) What electronic system, or non-electronic method, is used to register patients?


27) How long does registration take?


28) What useful statistics are available from the scheduling & registration systems/methods?


Appointments


29) On average, how many patients have their first appointment with your service per day/week/month?


30) Is the first appointment to begin service, or to perform intake/assessment? If the first appointment is to provide intake/assessment, how long does the patient wait from intake/assessment to first service appointment?


31) How many patients miss their first appointment due to communication errors?


32) Do you provide feedback to the referrer regarding the appointment outcome? If so, how?


Overall


33) What are your biggest headaches with the current access process?


34) Does batching (waiting for a certain number of tasks to build up) occur at any stage in the process?


35) Write a brief description of the service provided, the number and type of people providing the service, the hours of service availability and the service capacity (e.g., maximum caseload, visits per day, etc.).



Discovery of access processes isn’t limited to these questions, but they are a good start. Follow the rabbit down the hole when you stumble on something interesting with more questions and more observation.



Once you have collected this information, make the process visual by including all of your findings on a process map, which will help to clearly communicate your observations with others. Then, you will be ready to begin a truly informed discussion about improvement.

Crown made of silhouetted people holding hands, yellow background, radiant lines.
By Jeff Doleweerd June 27, 2024
A truly effective central intake hub is not merely a team of staff manually routing referrals behind a veil of complexity; it is an integrated system that dynamically combines public accessibility, algorithmic precision, real-time capacity management, and seamless communication to ensure patients receive timely and appropriate care.
Three people collaborating around a laptop, one holding a mug. Light teal background.
By Jeff Doleweerd May 14, 2024
Access to community healthcare is paramount for individuals across various stages of life — from seniors desiring to age gracefully in their own homes, to new parents seeking care for their infants and individuals in need of mental health and addiction support. Traditionally, when we mention referrals, the image of a physician sending a document to a specialist comes to mind. However, the landscape of healthcare referrals is evolving, and it's time to redefine our approach. Gone are the days when referral management systems solely relied on healthcare professionals. Take Caredove, for example. What was once considered a referral management system has transformed significantly to a multichannel access management platform. Surprisingly, 43% of referral activity now stems from direct public sign-ups. This shift is monumental, with a staggering 70-fold increase in public service requests compared to pre-pandemic levels in 2019. Clinician referrals will be the minority of service requests activity in our platform by the end of 2024. Why this paradigm shift? During the pandemic, communities learned the importance of direct access to essential services. The notion of gatekeeping community services in any manner like specialist services became obsolete. The crisis strengthened the muscles of direct access, emphasizing the significance of preventive health through social and other services that keep people out of hospitals and other care facilities. Moreover, primary care is under immense strain, with 15% of Canadians lacking consistent access to ongoing primary care. In such a scenario, burdening already stretched healthcare professionals with more referral duties is not sustainable. Accessing services directly not only expedites the process but also empowers individuals to take charge of their own health journey. It signifies readiness for change and recovery, without the artificial requirement of seeing a physician solely for a referral. Primary care remains crucial, and it's imperative to equip them with resources available at their fingertips, enabling them to navigate the healthcare landscape autonomously. After all, patients trust their primary care providers, and we should harness this trust. We also need to foster a culture of self-advocacy and consumer empowerment as part of a broader solution. Community agencies are champions of a healthcare system where individuals are empowered to take control of their health, supported by a network of trusted professionals. In an era of putting patients before paperwork, it is time to embrace direct access and take every bit of unnecessary administrative burden off family doctors and nurse practitioners, in the process.
Two people communicating using string phones, standing on separate rooftops over a gap.
May 10, 2024
In the landscape of mental health support, a new trend is emerging: rapid access low-barrier walk-in counseling. This innovative approach is reshaping how individuals access mental health services, providing immediate support without the traditional hurdles of scheduling. At Caredove, we're witnessing the transformative power of collaboration among organizations delivering these services. Let's delve into why this trend is not just groundbreaking but essential. Immediate Suppo rt : Imagine being able to get the help you need right when you need it, without waiting weeks for an appointment. That's the promise of rapid access low-barrier walk-in counseling. It ensures that no one falls through the cracks during times of crisis. Reduced Stigma : By offering low-barrier access, we're sending a powerful message: seeking therapy for mental health concerns is not only acceptable but encouraged. This approach helps break down the stigma surrounding mental health, making support readily available and easily accessible. Increased Accessibility : Not everyone has the means to access traditional counseling services. Some regions have been able to eliminate cost barriers, thereby ensuring that everyone, regardless of financial situation, can access the support they need to thrive. Community Building : Low-barrier walk-in counseling centers can become community hubs, fostering a sense of belonging and support. Preventative Approach : By addressing mental health concerns early and proactively, these services can prevent more serious issues from developing later on. Empowerment : Rapid access low-barrier counseling empowers individuals to take charge of their mental health. By providing immediate support and resources, we're giving people the tools they need to overcome challenges and live fulfilling lives. Cost Savings : While offering these services may seem like a costly investment, it can actually save money in the long run. By addressing issues early, we can reduce the need for more expensive interventions down the line. No physician burden : Rapid access counseling requires no physician referral so does not tap the resources of overextended primary care, or present barriers for unattached patients. Progressive Approach : Embracing rapid access low-barrier walk-in counseling reflects a progressive mindset in healthcare. It's about prioritizing the well-being of all in the community. Stepped Care approach : Rapid access can operate in a stepped care model. During the session, if more specialized services are identified as necessary, individuals can be seamlessly referred to these services by their therapist. Rapid access low-barrier walk-in counseling represents a seismic shift in how we approach mental health support. By embracing collaboration, we can amplify its impact, ensuring that everyone has access to the help they need, when they need it. Together, we're not just changing lives; we're changing the conversation around mental health..
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