AIM’s Vision: Accessible, effective healthcare for all Albertans.
AIM’s Mission: To support healthcare teams to create a culture of improvement through the use of evidence informed principles, resulting in access to care that is both timely and effective.
AIM Alberta is a quality improvement initiative that enables healthcare teams to achieve their potential. AIM equips these teams with the tools to identify roadblocks to success and create their own solutions to enhance patient access, efficiency and improve patient-centered interactions and self-management.
AIM Alberta works collaboratively with our partners in primary and specialty healthcare delivery to achieve that vision of seamless care focused on the needs of each individual patient to ensure the best possible outcomes. The AIM Alberta team is dedicated and committed to serving our partners in healthcare. As such, we are vested in ensuring that patient care is well coordinated at all levels. Beyond the Patient’s Medical Home, we are working within the Medical Neighbourhood. This means that primary care services are integrated with specialty care needs. In the Medical Neighbourhood, all of the providers are working seamlessly to ensure patients have timely access to whatever care they need, when they need it.
Increasing access to your practice is an essential element of a high functioning, patient centered, healthcare system. Access principles include:
Primary Care Access
- Balance Supply and Demand for Appointments
- Reduce demand
- Optimize the Care Team to increase supply
- Reduce Scheduling Complexity
- Contingency Plans
- Backlog Reduction
Specialty Care Access
- Understand and balance supply and demand
- Reduce backlog
- Reduce appointment types
- Develop contingency plans
- Reduce demand
- Optimize care team to increase supply
Office efficiency addresses delay across the office and with patients’ appointments for healthcare teams to consider how to optimize their work setting to enhance patient care.
Office Efficiency (Primary and Specialty Care)
- Balance Supply and Demand for Non- appointment work
- Synchronize all components of the appointment (patient, provider, information, room and equipment)
- Predict and anticipate needs
- Optimize the environment
- Manage constraints
Patient-centered interactions encourage patients to expand their role in decision-making, health-related behavior change and self-management. Patient-centered practices respect patients’ values and preferences, and this is reflected in the way the practice is designed. Communication is in a language and at a level the patient can understand, and data on patient demographics and preference is widely accessible. Principles of patient-centered care inform organization-wide decisions and interactions with individual patients.
Key changes for Patient-Centered Interactions:
- Respect patient and family values and expressed needs.
- Encourage patients to expand their role in decision-making, health-related behaviors and self-management.
- Communicate with their patients in a culturally appropriate manner, in a language and at a level that the patient understands.
- Provide self-management support at every visit through goal setting and action planning.
- Obtain feedback from patients/families about their healthcare experience and use this information for quality improvement.
The tasks that individuals must undertake to live well with one or more chronic conditions. These tasks include having the confidence to deal with medical management, role management and emotional management of their conditions.
Report of a Summit. The 1st Annual Crossing the Quality Chasm Summit. September 2004
Patient Self-Management involves understanding:
Predisposing Factors: knowledge, beliefs, attitudes, values, motivation, confidence and self-efficacy of the patient.
Enabling Factors: Health-related skills, Accessibility to information, and accessibility of health resources
Enabling patients in new tasks:
- Recognizing and acting on their symptoms
- Making most effective use of their medications and treatments
- Dealing with acute attacks or exacerbations (managing emergencies)
- Maintaining their nutrition and diet
- Maintaining adequate exercise
- Giving up smoking
- Using stress reduction techniques
- Interacting effectively with their health providers
- Using community resources
- Managing work and the resources of employment services (adapting to work)
- Managing relations with significant others
- Managing their psychological responses to illness
Collaborations & Partnerships
Alberta Medical Association
One of our most important partnerships in primary care is with the Alberta Medical Association (AMA). The AMA program teams work in partnership with AIM Alberta Senior Improvement Consultants to design, develop and deliver solutions with PCNs to support their PMH goals. Key collaborations with the AMA include planning the biannual PCN Strategic Leadership Forum, Accelerating Primary Care Conference as well as development and delivery of healthcare team development educational tools and resources
Alberta College of Family Physicians
The Alberta College of Family Physicians (ACFP) adopted the LEADS in a Caring Environment Leadership Framework and has since been involved in an emerging partnership in the key area of leadership development. AIM Alberta seeks to establish physician champions and support their evolution to becoming leaders in specific PMH domains such as QI and enhanced access.
Alberta Health Services – Quality and Healthcare Improvement
In an effort to help support all AHS community and outpatient ambulatory specialist services, AIM as well as the provincial QHI and zone Integrated Quality Management teams, have partnered to ensure common approaches are used and resources shared. In particular, AIM is excited to be partnering with the provincial QHI team to design a common enhanced access platform for all consultants to use when working with specialist physicians and their teams.
Alberta Health Services – Path to Care
Path to Care is an Alberta Health Services program that works closely with scheduled services to transform access to care by standardizing standardize referral, wait list and wait time management processes. This work helps ensure patients receive the right care, at the right place and at the right time. AIM collaborates with Path to Care to align tools, resources and supports in an effort to provide complementary services to specialist teams looking to enhance access to, efficiency of, and transitions between specialty services.
One of the many resources that the Path to Care team manages is the Alberta Referral Directory (ARD), which is an online resource for healthcare providers that centralizes referral and consulting physician information across the province. The ARD recently relaunched with improved access, a fresh design and enhanced referral information. Healthcare providers can now search the ARD without logging in and find service/consultant demographics, specific referral guidelines and detailed instructions to facilitate effective referrals at albertareferraldirectory.ca.
Patients Collaborating with Teams (PaCT)
Patients Collaborating with Teams (PaCT) is a partnership between Alberta Health Services (AHS) and the Alberta Medical Association – Toward Optimized Practice (AMA TOP) supported by patient representatives, the Health Quality Council of Alberta (HQCA) and the Alberta Cancer Prevention Legacy Fund (ACPLF). PaCT is an initiative designed to improve care planning for patients who require significant support to maintain their health. At the heart of PaCT is the support to primary care providers and their teams to reach those patients who need care the most, and shift the conversation from, “What’s the matter?” to “What matters to you?”
PaCT builds on the foundational work underway by Primary Care Networks (PCNs) and member clinics in implementing the Patient’s Medical Home. It supports bringing patient centred interactions, improvements in access, screening and panel together to support care coordination.
To learn more about PaCT, please refer to the FAQs or visit the TOP website.
To be a pioneer in this area, test new ideas, and garner support you need to advance your care coordination, please consider applying as an “Innovator Hub”.
If you would like more information, please contact firstname.lastname@example.org.
Primary Health Care Integration Network
The Primary Health Care (PHC) Integration Network is a customized Strategic Clinical NetworkTM (SCN) that was established to improve health outcomes and patient/provider experiences, while addressing challenges in Alberta to reduce spending in healthcare. The Network will facilitate new and innovative ways of delivering care throughout the province by connecting academic research, clinical evidence and innovation with front-line providers to adopt local best practices and coordinate services. They will work with partners to find solutions for common challenges in the system, such as long wait times, transitions in care and lack of access to specialists or other services.
AIM Alberta is a proud partner of the PHC Integration Network and will support initiatives focused on improving access, better continuity in transitions of care and coordinated supports (including quality improvement, measurement and evaluation).