Ambulatory Clinic Case Study Essay
Introduction The following project for leadership experience is set in an ambulatory clinic environment. The aim is to take an existing problem and formulate a convincing resolution that could be implemented. Physical implementation is not a requirement, but the hope is that this proposal will lead to action, which will in turn resolve the issue that is devaluing patient experience at present.
A1. Identification of a Problem
The recognized dilemma is timely patient access to care. Lack of access or longer waiting periods between appointments leads to patient dissatisfaction, negatively impacting our vision for quality of care. Following discussion with the unit administrator there is an understanding that this is a current, real problem that …show more content…
needs a solution.
A1a. Explanation of the Problem
The setting affected is a specialty ambulatory care clinic., within a large health care organization. This concern is applicable to the present environment because currently there are not enough physicians to manage the volume of patients. The effect of this is that patients can wait as much as 6-8 weeks for non-urgent cases. This issue causes frustration for both patients and clinicians.
Access to healthcare is an issue that is affecting not only this environment, but the whole Nation. Per Healthy People 2020 (2014) “Access to health care services in the United States is regarded as unreliable; many people do not receive the appropriate and timely care they need.”
A2. Investigation of the Problem
Initiation of this inquiry started with the chosen unit to confirm this was a topic worth pursuing. Information was gathered from physicians, nurses and the unit administrator. Data sources also include an exploration of web based resources encompassing governmental data, news articles and professional research papers from a similar environment with equivalent issues.
A2a. Evidence of Problem Patients are waiting an average of 18 days to schedule an appointment to see a doctor, according to a study of appointments for commonly used specialty physicians in 15 major U.S. cities, Japsen, B. (2014). This article shows the increasing problem of timely access across the United States. The article suggests that an aging population of baby boomers and an increase in people with health insurance may be contributing to this.
Despite the statement of the above article there is some improvement in access since 2014. Oregon Health Authority (2015) show a small improvement in access to effective and timely care in their 2015 data. However, it is vital to realize that the progress is minimal and much needs to be done to implement further change and improve quality, in conjunction with access to care.
Many of the articles reviewed suggest that changes in scheduling by the provider, plus a change in the supply and demand of provider/patient due to the Affordable Care Act, are all playing a role in the access concern.
The number of Americans over 65, being the segment of the population most in need of health care, is expected to double by 2060, according to 2012 statistics by the Census Bureau, Waseem, F (2013). The problem of access in specialty care clinics is not exclusive to the chosen environment. This is seen in a case study from a similar domain that was enacted by a surgical specialty medical practice to improve customer service and access for its patients. The motivation for the case study was a consequence of complaints from patients to their doctors, indicating that the specialty practice had problems with customer service and access, that is the ease with which patients can contact the practice, gain entry, and use the practice’s services, Ingram Quigley, D. (2011).
The above data resonates with what is seen in the clinic setting being reviewed. Patients are often frustrated by cancellations or access restrictions due to patient demand and physician supply. Data from the current environment shows, as noted above, that patients are waiting anywhere from 6-8 weeks for appointments and those patients who need to be seen more urgently will be double booked with other patients putting pressure on physicians and nurse and increasing the waiting time for
patients
A3. Analysis of the Evidence Some clear themes seem to be evident. The above data suggests that there is an increase in demand, which translates into a greater number of patients, and a decrease in supply equating to less physicians. The data suggests that small improvements are being made to aid the situation but that more progress is necessary. Patients are frustrated by the inability of healthcare services to provide timely access and this delay impacts their quality of care. If a patient leaves without being seen, their care is impacted even further as their recovery time is prolonged as care of their condition is impeded. They may eventually follow up with a provider who does not fully understand the specialty need they were being seen for. An example of this may be a urology patient with pelvic pain who is unable to gain access to his urologist and must instead see his Primary Care Provider who diagnosis him with urinary tract infection or kidney stones when he may have prostatitis.
A3a. Areas contributing to the problem There are several contributing factors that are indisputable. These factors include low nurse staff levels, not enough physicians to support growing numbers of patients, and physician cancellations due to illness or family emergency. This causes a backlog and leads to a decreased ability to provide care. Other major factors involve the baby boomer generation who are now becoming seniors and thus have increasing healthcare needs. Furthermore, the Affordable Care Act means that more people than ever have health insurance, the reflection of this seen in the increased need for access to care.
A1. Identification of a Problem
The recognized dilemma is timely patient access to care. Lack of access or longer waiting periods between appointments leads to patient dissatisfaction, negatively impacting our vision for quality of care. Following discussion with the unit administrator there is an understanding that this is a current, real problem that …show more content…
needs a solution.
A1a. Explanation of the Problem
The setting affected is a specialty ambulatory care clinic., within a large health care organization. This concern is applicable to the present environment because currently there are not enough physicians to manage the volume of patients. The effect of this is that patients can wait as much as 6-8 weeks for non-urgent cases. This issue causes frustration for both patients and clinicians.
Access to healthcare is an issue that is affecting not only this environment, but the whole Nation. Per Healthy People 2020 (2014) “Access to health care services in the United States is regarded as unreliable; many people do not receive the appropriate and timely care they need.”
A2. Investigation of the Problem
Initiation of this inquiry started with the chosen unit to confirm this was a topic worth pursuing. Information was gathered from physicians, nurses and the unit administrator. Data sources also include an exploration of web based resources encompassing governmental data, news articles and professional research papers from a similar environment with equivalent issues.
A2a. Evidence of Problem Patients are waiting an average of 18 days to schedule an appointment to see a doctor, according to a study of appointments for commonly used specialty physicians in 15 major U.S. cities, Japsen, B. (2014). This article shows the increasing problem of timely access across the United States. The article suggests that an aging population of baby boomers and an increase in people with health insurance may be contributing to this.
Despite the statement of the above article there is some improvement in access since 2014. Oregon Health Authority (2015) show a small improvement in access to effective and timely care in their 2015 data. However, it is vital to realize that the progress is minimal and much needs to be done to implement further change and improve quality, in conjunction with access to care.
Many of the articles reviewed suggest that changes in scheduling by the provider, plus a change in the supply and demand of provider/patient due to the Affordable Care Act, are all playing a role in the access concern.
The number of Americans over 65, being the segment of the population most in need of health care, is expected to double by 2060, according to 2012 statistics by the Census Bureau, Waseem, F (2013). The problem of access in specialty care clinics is not exclusive to the chosen environment. This is seen in a case study from a similar domain that was enacted by a surgical specialty medical practice to improve customer service and access for its patients. The motivation for the case study was a consequence of complaints from patients to their doctors, indicating that the specialty practice had problems with customer service and access, that is the ease with which patients can contact the practice, gain entry, and use the practice’s services, Ingram Quigley, D. (2011).
The above data resonates with what is seen in the clinic setting being reviewed. Patients are often frustrated by cancellations or access restrictions due to patient demand and physician supply. Data from the current environment shows, as noted above, that patients are waiting anywhere from 6-8 weeks for appointments and those patients who need to be seen more urgently will be double booked with other patients putting pressure on physicians and nurse and increasing the waiting time for
patients
A3. Analysis of the Evidence Some clear themes seem to be evident. The above data suggests that there is an increase in demand, which translates into a greater number of patients, and a decrease in supply equating to less physicians. The data suggests that small improvements are being made to aid the situation but that more progress is necessary. Patients are frustrated by the inability of healthcare services to provide timely access and this delay impacts their quality of care. If a patient leaves without being seen, their care is impacted even further as their recovery time is prolonged as care of their condition is impeded. They may eventually follow up with a provider who does not fully understand the specialty need they were being seen for. An example of this may be a urology patient with pelvic pain who is unable to gain access to his urologist and must instead see his Primary Care Provider who diagnosis him with urinary tract infection or kidney stones when he may have prostatitis.
A3a. Areas contributing to the problem There are several contributing factors that are indisputable. These factors include low nurse staff levels, not enough physicians to support growing numbers of patients, and physician cancellations due to illness or family emergency. This causes a backlog and leads to a decreased ability to provide care. Other major factors involve the baby boomer generation who are now becoming seniors and thus have increasing healthcare needs. Furthermore, the Affordable Care Act means that more people than ever have health insurance, the reflection of this seen in the increased need for access to care.