AIM Glossary of Terms
General Terms
Access
Acton Period
Advanced Access
Model
Backlog
Carve-Out Access
Model
Patient/Client
Satisfaction Survey
Collaborative Call
Contingency Planning
External Demand
Demand Types
(Streams)
Flow (Process)
Mapping
Internal Demand
Ability of patients to obtain an appointment with the provider on the day
he/she would like to see the provider
The period between Learning Sessions when teams act upon what they
learned
This model eliminates the distinction between urgent and routine and
requires practices to ‘do all of today’s work today’. See article by Dr.
Murray & Associates at http://www.aafp.org/fpm/2000/0900/p45.html for
further details
Defined as the ‘warehouse’ of work that has accumulated over time
This model on the access continuum ‘carves-out’ or holds a certain number
of provider appt. slots for specific types of visits (for example, hold four
short-appointments each day for urgent needs). See article by Dr. Murray &
Associates at www.aafp.org/fpm/2000/0900/p45.html for further details
A short questionnaire that provides health care clinics/program with
information and insight on their patient’s’ view of the services provided
Teams join a teleconference that includes all teams in the collaborative.
Occurs twice during the collaborative; half-way between Learning Sessions
2-3, and again between Learning Sessions 3-4
A prescribed recommendation for handling times of predictable events to
manage daily and seasonal variation (i.e. vacation or low supply
contingency planning). Demand exhibits a natural variation; supply exhibits
an artificial variation
Demand generated from "outside" from the clinic/program; i.e. walk-ins or
pt. calling in for an appointment
Usually defined as internal and external demand in primary care. Counted
on the day of request for service; not the day service will be provided.
An efficiency measure where teams ‘map’ out the steps of any process and
analyze for constraints, redundancy or ways the process can be improved in
a facilitated process.
This is initially done manually with post-it notes and markers. Upon
completion, the map can be transferred to an electronic format
Demand generated internally: i.e. a provider asks a pt. to come back for a
f/up or return appointments and appointments is made while pt. in clinic
for original appointments. Within specialty programs, internal consults to
various disciplines can also constitute same.
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Healthcare Team
Effectiveness (HTE)
IHI (Institute for
Healthcare
Improvement)
Learning Session (LS)
Levels of Maps
Max-Packing
Model for
Improvement
Office Efficiency
Pre-work
Storyboard
Traditional Access
Method
Walk-through
Written Reports
A team strengthening program. Team members take an "on-line" survey
that rates team performance in key categories.
All team leads take the training session and get a toolbox of techniques to
apply in "weak" team areas.
An American leader in healthcare quality improvement. IHI developed the
Model for Improvement and the basis for Alberta AIM
An in-person session during which participating clinics/programs meet as a
group with faculty and facilitators to collaborate and learn new concepts in
specific topic areas. Currently, there are 5 learning sessions of 1.5 days.
Reference to flow mapping of processes. There are 5 levels of maps (see
article by Dr. Mark Murray)
Maximizing appt to decrease return visit rate (RVR) – do more than one task
to save future appt time
An approach to process improvement developed by Associates in Process
which helps teams accelerate the adoption of proven and effective changes
and is the learning model upon which Alberta AIM was based. Original
faculty was Dr. Murray and Associates
Efficiency "at the medical appointment"
A session, usually held about 6-8 weeks before the first learning session,
when we meet with teams and give them an overview of AIM and get them
started on initial measures.
A tri-fold display teams develop to tell the "story of their team". They bring
it to learning sessions and share their journey and successes/challenges
A second system in the access continuum whereby the schedule is
saturated with squeeze-ins and urgent cases added by double booking;
skipping lunch; working late; running behind. See article by Dr. Murray &
Associates at www.aafp.org/fpm/2000/0900/p45.html for further details
A journey through the office visit through the patient's point of view.
Usually done by a team member or the facilitator. Documents the journey
from calling in for appointment through to completion. Is done to give an
impartial view to identify gaps or areas that might pose constraints for pts.
Uses a set template. Teams document their journey notes. Completed and
sent to faculty twice during collaborative; before LS 3 and again before LS 4
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Measurement Terms:
Activity
Analysis File
Care Team Work
Load Analysis
(CTWLA)
Cycle Time
Continuity
Deflection
Demand
DSA
Future Open
Capacity
No Shows
An access and retrospective measure that tracks the amount of work actually
done in a day (usually measured in time increments/slots). Activity =
appointments completed + squeeze ins – no shows. No shows get counted as
demand but never materialize as activity
Excel tool that is linked with the tracking spreadsheet. It analyzes data and makes
graphs in the specific measurement areas: i.e. no-shows, delay, DSA, etc.
A tool that can be analyzed and present visual information on workload. This can
be used to inform decision–making and capacity planning
An efficiency measure that can involve pt. participation. Using a paper form, it
tracks the pt.'s progress through the office visit. Times are entered into the
spreadsheet and analyzed so constraints can be identified
The percentage of time a patient will see his/her own primary care provider
when receiving care. Measured as the number of visits a patient has with
his/her own provider divided by the number of total visits by the patient to the
clinic as a whole
A term that measures the number of patients who seek care elsewhere (i.e. ER,
MediCenter)
Measure counted at the end of the day and tracks demand for supply (i.e. pt.
appointment) for primary care (calls, fax, squeeze ins, walk-ins, no shows, email,
follow-up); Measured for specialty care by new and return appointment
This measure is counted as the number of appointments booked today or for any
day in the future. Not to be confused by the number of appointments completed
(Activity)
Refers to Demand, Supply, Activity
Is measured in percentage and determined by counting number of available
appointment slots per provider during a specified time. Count how many are
open and divide the number of open slots by the total number of slots (filled and
unfilled)
Measures the number of appointment who do not show up for a scheduled
appointment (indicates wasted supply/capacity). Teams need to agree on what
constitutes a no-show vs. a cancellation. Not to be confused with "left without
being seen"
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Panel Equation
(Actual,
Equitable/Shared
or Ideal)
Panel or
Caseload
Panel Report
PDSA
Red Zone
Return Visit Rate
(RVR)
Short
Appointment &
Long
Appointment
Supply (Capacity)
Third Next
Available (TNA)
Appointment
Tracking File
(spreadsheet)
An equation that helps to correctly match patients to providers and assign
accountability for clinical care. Actual panel size is the amount of patients seen
in the practice for one provider for the last 12 months; Equitable panel size is the
number of patients each provider should have if the current panel (workload) is
divided equally; Ideal panel size is based on an equation to show provider
capacity limit
An access measure that identifies the number of unique, identified patients
assigned to a particular provider
A provider/clinic requested report from Alberta Health that identifies unique
individuals seen by the practice within the last 18 months but based on the last
12 months of activity using a four-cut method (Cut 1: Patients seen exclusively by
one physician; Cut 2: Patients seen predominantly by one physician; Cut 3:
Patients seen the same number of times by multiple physicians cut by the same
sentinel exam (i.e. Physical); Cut 4: Patients seen same number of times by
multiple physicians with no sentinel exam – cut by who saw them last). A report
from the Health Quality Council of Alberta (HQCA) also available and uses a 6-cut
method
Stands for Plan, Do, Study Act. It is the cornerstone of the Model for
Improvement from the IHI. A tool used to plan and test a change for the purpose
of improvement (template PDSA forms available on shared drive)
Measured as provider visit time with patient/client
The percentage of patients/clients who make a return visit
In primary care short appointment slot usually 10 minutes
In primary care long appointment slot usually 20 minutes
An access and prospective measure of the number of time slots available for pt.
care (measure in same increments as demand and activity)
An access measure that demonstrates the delay. Select the appointment type
(short or long) and count the number of days until the third next available
appointment of that type. The first 2 available appointment slots are not
counted as ‘available’ as they may have been recent cancellations and not a
reflection of true access. This should be measured weekly on the same day and
time. Do not count held or carve-out time slots and count weekends as delay for
TNA is from the patient perspective
Excel spreadsheet teams use to insert their measures. Data is saved in this file
and added to as they move through the collaborative.
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