title: A conceptual idea to improve access in a complex health care system.
abstract: OBJECTIVE
  The purpose of this article was to briefly describe the Open Access model, a method of improving access to a health care organization, and a conceptual idea is proposed for complex organizations that want to engage in this improvement work. The target audience is health care organizations that want to improve access to their services but are challenged by the complexity of their processes.
  
  
  METHODS
  A case study presents an organization's experience with the Open Access assessment process. This process starts with quantifying an organization's supply and demand and then deciding how to reshape its capacity and implement other strategies. A high-leverage area to improve access is a standardized or predictable process that is streamlined or implemented for a specific group of patients.
  
  
  RESULTS
  Health care organizations are complex and have processes of care that are not explicit, in which services are rendered uniquely for each individual patient and it is difficult to see the harmony or patterns in how the work is done.
  
  
  CONCLUSIONS
  The underlying principles of the Open Access model can be adopted in a complex organization, if it is acceptable to do more exploratory work and create or increase opportunities for the right things to happen.
authors.affiliation: Center for Evaluative Clinical Sciences, Dartmouth Medical School, Hanover, NH 03755, USA. Karen.Homa@Dartmouth.edu
authors.forename: Karen
authors.initials: K
authors.lastname: Homa
mesh_terms: D000046:Academic Medical Centers / Q000458:organization & administration*; D017598:Efficiency, Organizational; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans; D016015:Logistic Models; D008511:Medicine; D017146:Models, Organizational; D009513:New Hampshire; D019982:Organizational Case Studies; D013038:Specialization; D013122:Spinal Diseases / Q000628:therapy*