Access: Opening the doors for patients at Michigan Medicine
When a patient wants to receive care at Michigan Medicine, they should be able to see the right provider at the time they need and at the location that is most convenient to them.
That is the vision for patient access at Michigan Medicine.
However, many patients encounter roadblocks when they come to the organization. Wait times sometimes extend to weeks to see a particular provider or get into a specialty clinic. As a result, patients have a bad experience even before they step through the front door.
Many patients then seek care with other health care providers or other health systems.
“Access is about understanding the demand of our clinical services, the capacity we have to meet that demand and balancing both in the most effective way possible for patients, providers and staff,” said Hitan Kamdar, administrative director of patient access and insights. “This is our challenge, and we are working toward making this experience better by starting with the basics.”
Bringing ‘everyone to the table’
Of the many access efforts underway at Michigan Medicine, the Office of Patient Experience (OPE) began working with departments and the U-M Medical Group (UMMG) to identify opportunities to improve access.
Specifically, OPE piloted a project with the Department of Internal Medicine to understand availability for new-patient and return-patient appointments by analyzing past data.
“We bring everyone to the table to discuss the access issues in each division,” said Jan Stevens, patient access liaison for the Office of Patient Experience. “Our faculty are supportive of the effort when they are able to participate in determining how access can be improved.”
The analysis revealed that clinics were working hard to bring in more patients, but were not utilizing the full capacity and functionality of their scheduling system.
The project team was able to offer a mix of strategies including: standardized appointment types, four-hour patient-facing blocks and utilizing physicians, residents, fellows, physician assistants and nurse practitioners working at the top of their licenses to improve access within the department.
In the four-hour blocks of times for providers, the team worked with faculty and clinics to determine the right ratio of new-to-return appointments and the length of each type of appointment.
Improvements in the scheduling system also helped the staff in call centers. Call center representatives were able to find new patient appointments more easily and were able to clearly define appointment types, thus reducing confusion.
All of these solutions have started to make an impact for patients, faculty and staff.
Over the past two years, divisions with the new appointment templates are showing improvements in the percentage of new patients being seen within two weeks.
In the clinics where the new scheduling is in place, the staff have noted that they have a predictable patient load, patients are moved to rooms faster and there is less gridlock in the waiting room.
“As we continue to engage more departments, we’re moving in the right direction to improve the patient experience by improving their access to care,” said Kamdar.
Other access initiatives
While the work that OPE and departments have succeeded at the clinic level, Michigan Medicine has taken some systemwide steps to open the door to U-M providers across the state.
Over the past two years, Michigan Medicine has built an affiliation with Metro Health and partnered with MidMichigan and St. Joseph Mercy Chelsea. These relationships allow streamlined transfers when patients need to be treated here, and there is also a Michigan unit at St. Joseph Mercy Chelsea to serve patients in that area.
The organization has also expanded its own offerings with newly-built clinics in West Ann Arbor and Brighton.
All of these efforts are geared toward meeting the goal of improving access, and ultimately, the patient experience.
“The organization is exploring all of the opportunities available to ensure we are serving our patients and families in the best way possible,” said Kamdar.