title: Primary care access improvement: an empowerment-interaction model.
abstract: Improving community primary care access is a difficult and dynamic undertaking. Realizing a need to improve appointment availability, a systematic approach based on measurement, empowerment, and interaction was developed. The model fostered exchange of information and problem solving between interdependent staff sections within a managed care system. Measuring appointments demanded but not available proved to be a credible customer-focused approach to benchmark against set goals. Changing the organizational culture to become more sensitive to changing beneficiary needs was a paramount consideration. Dependent-group t tests were performed to compare the pretreatment and posttreatment effect. The empowerment-interaction model significantly improved the availability of routine and wellness-type appointments. The availability of urgent appointments improved but not significantly; a better prospective model needs to be developed. In aggregate, appointments demanded but not available (empowerment-interaction model) were more than 10% before the treatment and less than 3% with the treatment.
authors.affiliation: Graduate Faculty, Central Michigan University, Colleges of Extended Learning and Health Professions, Mount Pleasant 48858, USA.
authors.forename: G R
authors.initials: GR
authors.lastname: Ledlow
authors.forename: D M
authors.initials: DM
authors.lastname: Bradshaw
authors.forename: C
authors.initials: C
authors.lastname: Shockley
mesh_terms: D001071:Appointments and Schedules; D019985:Benchmarking / Q000458:organization & administration; D005858:Germany; D006297:Health Services Accessibility / Q000592:standards*; D006801:Humans; D008887:Military Medicine / Q000592:standards*; D008889:Military Personnel / Q000523:psychology*; D017146:Models, Organizational; D020380:Needs Assessment / Q000458:organization & administration; D015279:Organizational Culture; D009936:Organizational Innovation; D010358:Patient Participation; D018802:Patient-Centered Care / Q000458:organization & administration*; D011209:Power, Psychological; D011320:Primary Health Care / Q000592:standards*; D015397:Program Evaluation; D017749:Total Quality Management / Q000458:organization & administration*; D014481:United States / Q000208:ethnology