Building the Patient Access Habit

Industry,

By: Kevin Pawl and Susan Flath Sporn, Boston's Children Hospital

It’s no surprise to anyone that after the past few years of pandemic disruption to normal hospital operations, it is time to begin to reset expectations and best practices. The Patient Access world we lived in during 2019 is now different in 2022; patient backlogs are common, wait times while acceptable during active Covid response time were better are now getting worse, clinics are short staffed, and patients expect the flexibility Virtual Visits offered them over the past 3 years.

At Boston Children’s Hospital, we are experiencing various degrees of these issues just like everyone else and are using this time to reset Patient Access expectations and defining best practices in our ambulatory clinic areas. To do this, we are doubling down on traditional Access goals by looking at our priorities and asking ourselves:

“Can the patient get through on the phone and if they can, do we have the capacity to offer them an appointment with the right person, at the right time, in the location most convenient to them.”

Focusing on these two areas (telephony and capacity) is allowing us the space to ensure that our goals will help create space for patients to get the things they need. To support these goals, we have created a clearer feedback loop for our Access goals and developed an ambulatory training program we are calling the Access Bootcamp.

The first piece, sharing our goals is something we have done in various ways over the years, but we are resetting expectations of commitment to Access goals in a new way. This year, we have four Patient Access goals designed to help support improving capacity. What is new is the feedback loop we are providing departments. Each month we are publishing and publicizing every ambulatory department’s monthly performance on each of the goals. We can then easily identify how many areas are meeting none, some or all of our Access goals. This spreadsheet is published in a centralized location, emailed to local leaders, presented in ambulatory meetings, and shared widely with the Access Executive Committee. Since this change, we have noticed an increase in engagement and curiosity on how improving these measures impacts capacity, scheduling and the patient experience.

The second piece, is we developed a seven part training program we are calling the Access Bootcamp. The goal of the Bootcamp is to build on our reset expectations and help define best practices for areas. Over the past few years naturally local leadership changed, staffing levels fluctuated, templates became jumbled, and the patient experience was not cohesive across the hospital. The seven part series began with a series of Epic trainings on provider/schedule utilization and template best practices. The next few trainings were focused on call center staffing and quality assurance. The final two bootcamp trainings, scheduled for this fall, will look at Digital Health services and then additional reporting tools. Each ambulatory area identified at minimum one Access Champion to attend the bootcamp trainings and bring or share information with the local template manager, call center supervisor, or anyone else who many influence these decisions.

As we look to wrap up 2022 and move forward, with hopefully increasingly normal hospital operations, we plan to continue these activities. Resetting expectations and defining best practices will continue to be ongoing work supported by an increasingly transparent focus on goals and the training to support these operations.