Set out below are a series of short case studies showing some of the professional services and the outcomes from those services, that Alpha delivered on for our clients. We are always happy to provide further details of our previous experience and to outline how we can support new clients. Please CLICK HERE to contact us or make an enquiry.
- Better service level to Patient
- Relieve administrative stress & burden on GPs and Clinical Staff
- Improve practice efficiency & operation
- Use proven business strategies & processes
TQM -Total Quality Management, aspires to total customer satisfaction and focuses on the requirements of the customer – TQM focuses on “prevention” rather than “cure”.
Lean aims to get one process to do only what the next process needs when it needs it; lean value streams extends this concept to link all processes from customer back to initial process.
Value Added Manufacturing (in industry) looks at the manufacturing process in its entirety and breaks down every detailed action into a value add (VA) or non-value add (NVA) activity. Aim is to eliminate all NVAs.
5S – a philosophy that focuses on effective workplace organisation. It simplifies and enhances your work environment whilst improving quality and efficiency.
Kaizen Event – any action whose output is an improvement to existing process. Promotes a “hands- on, get stuck in” approach.
Alpha Healthcare has uniquely adopted a compilation of these techniques applicable to healthcare and has developed a system for the introduction of Value Added Care, VAC©, to GP Practices & Residential Care Centres.
“PATIENTS ARE NOT CARS” – A Case Study
How Industrialised Techniques helped
Background: GPs had invested in a substantive re-modernisation of their practice facility which involved adding new GP consulting rooms and upgrading all existing facilities. The practice wished to upgrade their practice systems to improve patient service and operational efficiency of the practice.
Work: Alpha Healthcare were requested to support the practice with this change program and the company applied its unique VAC© systems methodology to complete a diagnostic on the practice, recommend systems changes and introduce these to the practice.
Outcome: Alpha worked with the practice GPs & staff and introduced:
- Patient focused service measures leading to reduced wait times
- New workflow practices
- More efficient operational procedures
- Re-layout of internal back office
- Pro-active financial management systems
- Enhanced use of practice management software system
- New medical services at practice e.g. Minor Surgery
- Successful implementation & use of own prescribing formulary
- Clearly defined staff roles and responsibilities
- More GP free time to focus on patient care
- Higher levels of patient satisfaction e.g. reduced waiting times
- Increased practice revenue
- Happier work environment and staff morale
- More efficient operating practice
Comments from GPs on Alpha’s services:
“On a personal level, it has taken the administration load off me and apart from doing the actual work it has also taken the worry away” – Cork GP
“If only I had this service 20 years ago” – Kerry GP
Improving Patient Access at GP Practices
- Patients are often unable to access their GPs
- Never enough appointments and lack of same day availability to meet patient demand
- Increased clinicians workload due to access pressures
- Complex and inefficient systems and duplicate appointments
- High rates of DNAs
WHAT CAN ALPHA’S DEMAND MANAGEMENT ACCESS MODEL OFFER TO YOUR PRACTICE?
- Alpha will assist and develop practice staff in their understanding of access
- We will provide support in measuring and understanding your patient’s requirements
- We will provide the tools to analyse the practices current clinical capacity and demand
- We will equip your practice with change management skills and train practice staff to effectively manage access on an ongoing basis
- Alpha will provide specialist support to your practice from our experienced team of access and change management
“Alpha Primary Care supported us in addressing access issues with our patient base of more than 83,000 patients across the Harness Network” – Caroline Kerby, Co-Lead General Practice Network, NHS Alliance, Managing Partner Brentfield Medical
ALPHA’s DEMAND MANAGEMENT ACCESS MODEL
- Set up a system responsive to patient needs
- Remove duplicate demand
- Simplify access system
- Remove barriers
- Understand and efficiently utilise capacity
- Educate patients on access
- Manage demand for services
- Build on flexibility
HOW WILL ALPHA’s DEMAND MANAGEMENT ACCESS MODEL HELP YOUR PRACTICE?
- Improved access for Patients
- Shared workload between all clinicians
- Reduce pressures across the practice caused by poor access
- A simpler, more straight forward system for all
- Greater understanding of demand management
- Eliminate / reduce duplication in workload – clinical & administrative
- Provide staff with the tools and skills to monitor future demand on the practice
“APC supported us in completely overhauling our access system leading to a 20% improvement in less than 6 months. Patient satisfaction improved and pressures on GPs around access were greatly eased” – Dr. Jez Watson, GP Partner, Birtley Medical Group, Newcastle (15,000 patients)
“APC gave us the evidence, training and tools to effect change in our access system”
Case study: Medical Group – North East England
Medical Group has approximately 14,000 patients and is situated in North East England in a predominately industrial area.
Main Reasons for Change:
- Patients unable to access their preferred GP and restriction son book ahead options,
- Existing system was complex,
- Lack of appointments to see patients on the same day,
- Clinicians unhappy with system,
- Average number of patient contacts with surgery per year was much higher than regional benchmark thereby creating an increased demand on clinical capacity.
Aims & objectives of new service
- Provide patients with improved access to their preferred GP,
- Simplify system for patients, GPs and staff & be consistent in its use,
- Establish a system where all GPs work more closely to share and balance patient appointment demand,
- Aim to reduce unnecessary telephone calls,
- Address all patients calls for appointments first time (eliminate/reduce call-backs and unnecessary calls for the GPs/nurses),
- Reduce patient seeing two GPs when one visit will do,
- System to be responsive to patient needs, efficient and allow some flexibility for GP consulting styles,
- Reduce patient demand levels (inefficient or duplicate demand) whilst maintaining exiting GP capacity; aim is not to force extra work on GPs – reduce average number of patient contacts with surgery to regional benchmark levels.
Access System Analysis:
- Detailed analysis of exiting daily and weekly patient demand – analysed daily, weekly and monthly appointment levels and demands for same day appointments,
- Reviewed clinical capacity,
- Completed patient survey and detailed feedback analysis (as part of the Patient Participation Group initiative),
- Completed detailed supply v demand analysis.
- All system changes were based on the introduction of APC’s defined capacity /demand management system which was then “tailored” to meet the specific requirements of the practice,
- Introduced standardised Clinic start times,
- Extended patient book forward period to 6 weeks,
- The concepts of “emergency and Duty” doctor were eliminated and the complex clinical appointment system abolished,
- A standard approach to clinics where each GP does a mix of routine appointments, same day (or urgent) appointments and telephone consultations was introduced,
- A “Doctor on call” position was defined which had a clinic similar to above but with some of the “standard” clinic appointments changed to “urgent” appointments with a much more balanced workload on this doctor,
- The availability of appointments (capacity) was managed to ensure a good balance between same day and routine appointments.
A daily demand management system was introduced to make all staff, including clinical, aware of the excessive appointment demand. Clinical staff committed to the new system that they would react and support accordingly depending on the warning status;
|GREEN||Appointments ok – demand manageable|
|RED||Some more appointments necessary – agreed extra (limited number) appointments to be added to each GP during the day|
|YELLOW||Very high patient demand; extra appointments necessary; agreed extras to be added to each GP during the day; cancel any unnecessary meetings; overflow patients to be directed to walk in centre.|
Key Outcomes of new service:
The access system at the practice was independently evaluated and compared with other practices, before and after these changes:
- Pre-changes – data showed that the practice had an average consultation rate equivalent to 8.17 patient contacts/year,
- Within 6 months – data showed the practice had an average consultation rate equivalent to 6.41 patient contacts/year,
- This is a 21.5 % improvement in 6 months,
- It is estimated that it will take a full year for all the real benefits of the changes we have made to the access system to materialise as it take this amount of time for all the patients at the practice to become familiar with and accustomed to a new system.
Notable improvements are:
- Patients are now consistently able to book an appointment on the day if they need a same day appointment,
- Patients have much greater access to their preferred GP,
- The system is significantly simplified and there is a lesser chance (not eliminated yet) that patients are double booking,
- The reception staff handle all patient queries as they call – they have practically eliminated telling patients to call back (which was generating a lot more work),
- The overall workload is now more balanced amongst clinicians,
- The “triaging” of patient requests by the reception staff re a routine v an urgent appointment appears to be working well.
This is really just the beginning of the process – the positive improvements have taken pressure off the clinicians, staff and the system.
Further identified improvements are:
- The system still has “stressor” points when they is very high demand for appointments and in some instances too many extras are added for clinicians,
- The availability of appointments is still not flexible enough to properly respond to demand – i.e. having the right number of appointments – not too many and not too little and having a “response mechanism” in place when additional “peaks” are encountered,
- Telephone calls workload seems to vary significantly – which makes it difficult to staff appropriately.
|Mallow Primary Healthcare Centre (MPHC)|
|Mallow GP Consortium|
|70,000 sq ft|
|Program & project managers providing a full turnkey service to deliver a Primary Care Centre to the GPs.|
|Alpha Healthcare were engaged by the Mallow GP Consortium to assist in the development of the primary care centre for the area. Alpha worked with the GPs and HSE to deliver the project from conception to handover.|
Program & Project management involved:
- Site Selection
- Planning Co-ordination
- HSE Negotiations
- Construction Management
- Centre Fit-Out
- IT / IS Sourcing
- Furniture Fit-Out
- A full project feasibility exercise was completed with an evaluation of a number of different site and development options.
- Alpha completed negotiations with the HSE and other partners involved in the project.
- MPHC was the first Primary Care Centre in the country to sign up the HSE under its current PCC Building Progress.
- Castlelands Construction and the Gouldshill site were selected by the group.
- All stakeholders, the GP Consortium and HSE personnel inputted at design stage of the project.
- Significant attention was placed on the requirement for the building to be patient and environmentally friendly.
- Planning for the project was submitted in April 2007; there were no objections or observations – an endorsement by the Mallow people of the need for such a facility for the town. Full planning permission was received in December 2007.
- Sisk’s were appointed main contractor and the major building project employed nearly 200 workers during the construction phase.
- Construction was completed in March 2010 and the internal fit-out began for all tenants with the official first day of operation of the centre 4th May 2010.
- The GP’s moved into the building and commenced full operation from the centre on 4th May 2010.
- The HSE and out of hours (South Doc) have also moved into the premises.
Ballina Medical Centre
Dr Sean & Dr Tom Moffatt
23,000 sq ft
Project Manager & Primary Care Specialist Advisor
The Ballina Medical Centre was opened on the 3rd October, 2011 by An Taoiseach Enda Kenny. The Centre incorporates two GP practices, an HSE primary care team, a pharmacy and some ancillary services.
Alpha’s scope of work:
- Developed a project plan with key milestones and timescales.
- Managed and tracked project milestones to plan.
- Provided independent expert advice on Primary Care Centre development.
- Liaised with commercial agent /specific groups re-leasing of medical retail units.
- Practice management organisational matters addressed prior to moving into the new centre.
- Negotiated outsourced management services for the building as required i.e. security and cleaning services.
- HSE commercial negotiations and liaison on all project matters.
- Support in the completion of legal contracts with the HSE.
- Support in the financing of the project.