Advanced Access:

Frequently Asked Questions

What is Advanced Access?

  • Advanced Access is a training and implementation process for reengineering clinic practices so patients can see a physician or other primary care practitioner at a time and date that is convenient for them. The Advanced Access model is much more than just another scheduling system. It is a comprehensive approach to effective patient care delivery.

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How much does it cost?

  • There is no cost for clinics to apply for and take Advanced Access training. Manitoba Health has received funding to support clinic training. However, fee-for-service clinics should expect some upfront costs from the need to dedicate resource time to the training and implementation of Advanced Access. Most clinics experience a return on these upfront costs, because once Advanced Access is implemented, it has demonstrated increased billings due to improved office efficiency and the reduction in patient "no shows".
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Why is the province sponsoring Advanced Access training?

  • A priority of Manitoba Health is improving access to primary care. Advanced Access is one strategy being implemented to achieve this.
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Who has taken Advanced Access training so far in Manitoba?

  • Through the government sponsored training program, more than 30 clinics have been trained since 2007 to implement Advanced Access. Manitoba's goal is to support 75 per cent of primary care clinics in Manitoba with Advanced Access training and implementation by 2015.
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Who provides the training?

  • Manitoba Health has contracted experts to provide the training. In addition, the Department of Family Medicine at the University of Manitoba Continuing Medical Education and the contractor have used a train-the-trainer model to expand the training capacity in Manitoba.
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What support is provided to clinics that join the program?

Through participation in the initiative clinics will have access to a variety of resources to assist them. These resources include:

  • one orientation workshop;
  • in-person learning workshops (up to a maximum of eight days);
  • written materials to support topics covered at the learning workshops;
  • access to a facilitator to help set aims, take measurements, support reporting, hold meetings and complete team development work;
  • access to faculty and other participants for information-sharing and problem-solving during action periods;
  • access to measurement resources for assistance with spreadsheets, data collection and panel identification;
  • monthly teleconferences with faculty and other participating clinics to share learning and ideas; and
  • access to group email and website for posing questions and sharing information.
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What affect will this have on primary care clinic staff?

Staff will:

  • work at their full scope of practice to reduce practice overlaps and inefficiencies;
  • become experts in their patients' needs;
  • function as a team (physicians, nurses, administration, other health care professionals);
  • experience increased job satisfaction; and
  • have increased revenue for fee-for-service clinics.
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What effects will this have for patients?

Patients will:

  • have better access to health care services;
  • have decreased wait for and at appointments: be able to book appointments on the same day, within a few days or at a time that is convenient for them;
  • have decreased visits per year: multiple issues will be addressed in one visit;
  • be able to see their physician/provider of choice;
  • experience more efficient appointments; and
  • have health issues addressed earlier.
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What effect does Advanced Access have on the system at large?

  • Advanced Access ensures appropriate use of resources, eliminates unnecessary and duplicate services and ensures patients receive service at the right time, in the right location by the right provider.
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Are there any "success stories" in Manitoba?

  • Implementing Advanced Access is a unique journey for each clinic. Clinics develop access and efficiency goals, and timelines for implementation depending upon their assessment of need and capacity. Success is incremental. Participating clinics have expressed multiple successes and the desire never to go back to the "old way of doing business".
  • Clinics' success stories will be posted on the Pursuing Excellence website.
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How can clinics enrol in Advanced Access training?

  • Clinics wishing to implement Advanced Access principles will be asked to:
  • establish an access improvement team with at least one physician, administrative staff and other health professionals. Teams have consisted of as few as two and as many as 14 staff.
  • complete a Readiness Assessment and Application form.
  • participate in the 12 to 14 month implementation process which includes:
    • attending in-person learning workshops. It is expected that all members of the clinic's improvement team will attend all the learning workshops;
    • participating in monthly team conference calls;
    • preparing monthly reports that are submitted to the trainers for feedback;
    • administering staff and patient surveys upon completion of the implementation phase; and
    • implementing Advanced Access within their clinic. Specifically this involves:
      • understanding the clinic's practice;
      • working towards doing today's work today;
      • increasing office efficiency;
      • optimizing their clinic team; and
      • measuring, measuring and more measuring.
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Have previous Manitoba Advanced Access sites been evaluated to demonstrate outcomes?

  • Surveys were administered to staff and patients to determine the impact of implementing Advanced Access. Clinic staff:
  • expressed appreciation for the expert training and consultation provided by the trainers;
  • understand the concept of Advanced Access;
  • have the tools and training to sustain Advanced Access;
  • have seen tangible results from their work related to increased office efficiency, better patient access to appointments, staff able to function at full scope of practice, and the development of a positive work environment.

Patients indicated that:

  • they were able to get an appointment with the provider they wanted to see (increased continuity of care);
  • they were able to get an appointment within three days of calling their clinic; and
  • they were satisfied with the wait time to get an appointment.

All future clinics will be engaged in ongoing evaluation activities to both inform and improve the training and implementation strategy as well as to demonstrate benefits achieved.

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How does Advanced Access fit with other strategies underway in health care?

  • Advanced Access is based on Lean Six Sigma principles, which is the being used in a number of other health care improvement initiatives. Advanced Access differs in that it has been designed specifically for implementation in primary and specialty care clinics.
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Can any primary care clinic in Manitoba sign up for Advanced Access training and implementation?

  • Yes, all primary care clinics can participate. Specialty care clinic are out-of scope for this phase of the initiative.
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Will information sharing or networking opportunities between participating clinics be created?

  • Yes. Manitoba Health has created a Pursuing Excellence website which includes a section for Advanced Access. Participating clinics are encouraged to report and discuss their progress with each other, ask questions of each other. The website will also host practical tools and information to assist sites with implementation.
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Where else is Advance Access being tried?

  • Advanced Access is currently being implemented extensively in British Columbia, Saskatchewan and Alberta. Advanced Access was originated in the United States by Dr. Mark Murray, a family physician, and has been rolled out to numerous clinics stateside and over 30 other countries.
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If we don't enrol now, will there be other training opportunities?

  • The Advanced Access training strategy is a four-year strategy. Training and support sessions will be scheduled each year. Check back here for dates and details.
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Primary Health Care Branch
1090-300 Carlton Street
Tel:  204-788-6732
Fax: 204-943-5305