Issue: BCMJ, Vol. 52,
July, August 2010,
page(s) 310 GPSC
Improving practice efficiency for specialists
Following the success of the Practice Support Program (PSP) for general practitioners, a number of practice efficiency improvement learning modules are now being offered to specialist physicians around the province.
The Advanced Access Scheduling module is designed to help physicians manage their workflow and reduce patient wait times. At its heart is a disciplined approach to balancing a physician’s daily availability of time with the demands for that time.
Achieving a balance between the supply of and demand for their services enables physicians to start reducing the number of patients on their wait list and patient wait times.
Before implementing advanced access in his Penticton practice, orthopaedic surgeon Dr Cameron Taylor had a wait list of 186 patients. His lower priority patients faced wait times of 6 months to 1 year for an appointment, and even high-priority patients would sometimes be on hold for 2 months before a first consultation.
By introducing advanced access scheduling and some other efficiency improvements, Taylor now averages about 50 patients on his wait list and is able to schedule timely appointments for patients at all priority levels.
Similar success is reported by Vancouver endocrinologist Dr Marshall Dahl, who has eliminated his wait list and has expanded the capacity of his practice by 20% with the help of advanced access scheduling.
In addition to the advanced access module, specialists are also being offered modules on improving office efficiency and conducting group medical visits.
These learning modules will continue through the fall and are open to all specialists and their medical office assistants. Delivery of the modules is coordinated by the regional health authorities.
A number of training sessions will be held this fall to prepare provincial PSP physician practice leaders, champions for a series of new PSP learning modules being launched in the coming year. More detailed information about these train-the-trainer sessions, including times and locations, will be provided later this summer.
The training sessions will start in early fall and include the following:
End of Life/Palliative Care
This session, tentatively scheduled for September and chaired by Dr Cathy Clelland, supports a new module for GPs on the palliative approach to care for patients approaching end of life.
The module will provide training to help GPs identify these patients, assess their pain and symptom management issues, assist with advance health care planning, and ensure their referral to appropriate program or community resource for end-of-life care. The primary focus is on patients with serious chronic conditions and progressively declining health.
Prescribing Safety & Quality
This session, scheduled for September, supports a new learning module focused on changing the culture of prescribing among physicians. Dr Keith White is chair of the working group developing the module.
Shared Care (focus on COPD)
Tentatively set for October, this session supports a new learning module about shared care between family and specialist physicians for COPD patients.
The working group for this module is chaired by Dr Gordon Hoag and is developing a shared care referral, consult, and communication process for COPD patients that could provide a template for the shared care of other patients with chronic disease.
Child & Youth Mental Health
This session, tentatively scheduled for November, supports an expanded Child & Youth Mental Health training module based on a prototype conducted at Killarney High School in Vancouver last winter.
The prototype provided participating physicians with training and clinical tools for identifying, diagnosing, and treating adolescent depression. The need for improving the skills of GPs in this area is highlighted by statistics that show 6% to 8% of adolescents are affected by depression and that most adults who develop major depressive disorder experience their first episode of depression in their teenage years.
The PSP’s Child & Youth Mental Health learning module will address anxiety, depression, ADHD, and other significant areas of mental health.
Provincial Learning Session
The next PSP Provincial Learning Session is tentatively set for October in Vancouver. These twice-yearly sessions provide ongoing support for PSP regional teams through information sharing and new materials.
The sessions also offer an opportunity for PSP regional support team members from different health authorities to learn what is working in other areas of the province.
A particular focus for the learning session in October is increased training for medical office assistants.
—Liza Kallstrom, Executive Lead, Practice Support Program, BCMA