title: Improving Access to Care at Autism Treatment Centers: A System Analysis Approach.
abstract: The prevalence of autism spectrum disorder is steadily increasing and placing more demands on already overburdened diagnostic and treatment systems. A thoughtful, systematic reorganization of autism service delivery may reduce delays and better meet the growing need.
  
  
  
  Two clinical centers in the Autism Intervention Research Network on Physical Health, Cincinnati Children's Hospital Medical Center (CCHMC) and Nationwide Children's Hospital (NCH), undertook a year-long access improvement project to reduce delays to care by using system analysis to identify sources of delay and to target changes by using a set of defined access principles. Although both sites addressed access, they focused on slightly different targets (reducing number of patients with autism spectrum disorders waiting for follow-up appointments at NCH and reducing delay to new diagnosis at CCHMC).
  
  
  
  Both sites achieved dramatic improvements in their complex, multidisciplinary systems. A 94% reduction in number of patients on the waitlist from 99 to 6 patients and a 22% reduction in median delay for a new ongoing care appointment were realized at NCH. A 94% reduction in third next available appointment for new physician visits for children 3 to 5 years old was realized at CCHMC.
  
  
  
  This article demonstrates that 2 different clinical systems improved access to care for autism diagnosis and follow-up care by identifying sources of delay and using targeted changes based on a set of access change principles. With appropriate guidance and data analysis, improvements in access can be made.
authors.affiliation: Mark Murray and Associates, Sacramento, California;
authors.forename: June
authors.initials: J
authors.lastname: Austin
authors.affiliation: Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; patty.manning@cchmc.org.
authors.forename: Patricia
authors.initials: P
authors.lastname: Manning-Courtney
authors.affiliation: National Institute for Children's Health Quality, Cambridge, Massachusetts;
authors.forename: Meghan L
authors.initials: ML
authors.lastname: Johnson
authors.affiliation: Mark Murray and Associates, Sacramento, California;
authors.forename: Rachel
authors.initials: R
authors.lastname: Weber
authors.affiliation: Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio;
authors.forename: Heather
authors.initials: H
authors.lastname: Johnson
authors.affiliation: Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Autism Speaks Autism Treatment Network, New York, New York; and.
authors.forename: Donna
authors.initials: D
authors.lastname: Murray
authors.affiliation: Nationwide Children's Hospital, Columbus, Ohio.
authors.forename: Karen
authors.initials: K
authors.lastname: Ratliff-Schaub
authors.affiliation: Mark Murray and Associates, Sacramento, California;
authors.forename: Abbey Marquette
authors.initials: AM
authors.lastname: Tadlock
authors.affiliation: Mark Murray and Associates, Sacramento, California;
authors.forename: Mark
authors.initials: M
authors.lastname: Murray
mesh_terms: D000067877:Autism Spectrum Disorder / Q000175:diagnosis / Q000628:therapy*; D001321:Autistic Disorder / Q000175:diagnosis; D002675:Child, Preschool; D003937:Diagnosis, Differential; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans; D007223:Infant; D009820:Ohio; D013597:Systems Analysis; D014850:Waiting Lists