1. The UCSF Double Helix Curriculum:
Facilitator Guide
Time: 20 minutes
Audience: 1st – 3rd year residents
Objective(s): Understand how patient access for different care needs (same-day, acute, preventative, chronic care follow up, etc) can be tracked over time, and how to use this data to innovate systems to meet these needs
Transformation of High-Performing Primary Care in Education
The UCSF Double Helix Curriculum:

2. How to Measure and Interpret Access
Adapted from the Center for Excellence in Primary Care

3. The UCSF Double Helix Curriculum:
Key Measures
Metric
Definition
What to Look For
% Same Day Appointments
# of appointments that were scheduled the same day / # scheduled appointments
Meeting same day ratio targets
% open capacity
# open slots / # appointments available
There are enough appointments in the future to continue to book into
3rd Next Available
# days until 3rd open appointment
Should be =< 1
Transformation of High-Performing Primary Care in Education
The UCSF Double Helix Curriculum:

4. Appointment Scheduled The UCSF Double Helix Curriculum:
Same Day Appointments
Clinic Schedule
Appointment Scheduled
1:00
PM HUDDLE
1:20
TODAY
1:40
2 weeks ago
2:00
2:20
1 month ago
2:40
3:00
Yesterday
Transformation of High-Performing Primary Care in Education
The UCSF Double Helix Curriculum:

5. The UCSF Double Helix Curriculum:
Future Open Capacity
Identifies if the next 2 weeks/month/etc. has needed availability
Tracking this data helps to forecast scheduling and balancing of time off requests.
Data shows the total number of slots a provider has during a specified time period, how many are filled and how many are available.
Transformation of High-Performing Primary Care in Education
The UCSF Double Helix Curriculum:

6. The UCSF Double Helix Curriculum:
Future Open Capacity
Week
This week
Next Week
3 Weeks
4 Weeks
# Open 2 10 25 45
Total Appointments Available 50
Transformation of High-Performing Primary Care in Education
The UCSF Double Helix Curriculum:

7. The UCSF Double Helix Curriculum:
Future Open Capacity
Week
This week
Next Week
3 Weeks
4 Weeks
# Open 2 10 25 45
Total Appointments Available 50
Transformation of High-Performing Primary Care in Education
The UCSF Double Helix Curriculum: 82
200
= 41%
Future Open Capacity:

8. The UCSF Double Helix Curriculum:
Strategies to Improve
Meet with schedulers. Are same day appt declining and being used for pre-books/follow ups?
Lengthen return intervals
Is face to face follow up necessary or can it be done over the phone or by another team member?
Look at demand—do you need to increase or decrease same day ratio?
Transformation of High-Performing Primary Care in Education
The UCSF Double Helix Curriculum:

9. Third Next Available Appointment
“How long does our patient need to wait for an appointment?”
Transformation of High-Performing Primary Care in Education
The UCSF Double Helix Curriculum:

10. Third Next Available Appointment
Day of the Week
Mon
Tues
Wed
Thur
Fri
Sat
Sun
Open/Scheduled Appointments X
3rd Next Available Measure 1 2 3 4 5 6 7 8
Transformation of High-Performing Primary Care in Education
The UCSF Double Helix Curriculum:

11. Third Next Available Appointment
Day of the Week
Mon
Tues
Wed
Thur
Fri
Sat
Sun
Open/Scheduled Appointments X
3rd Next Available Measure 1 2 3 4 5 6 7 8
Transformation of High-Performing Primary Care in Education
The UCSF Double Helix Curriculum:

12. Third Next Available Appointment
Day of the Week
Mon
Tues
Wed
Thur
Fri
Sat
Sun
Open/Scheduled Appointments X
3rd Next Available Measure 1 2 3 4 5 6 7 8
Transformation of High-Performing Primary Care in Education
The UCSF Double Helix Curriculum:

13. The UCSF Double Helix Curriculum:
Strategies to Improve
Evaluate daily use of appt schedules with staff. Are same day appts slots being used appropriately?
Evaluate provider availability per demand needs (ie days scheduled)
Contingency plans for vacation, leave, illness
Transformation of High-Performing Primary Care in Education
The UCSF Double Helix Curriculum:

14. Creating Capacity Today
Simple Way
Create a “drop dead” date
Block appointments for same/next day access
Alternative Way
Bring in additional supply in order to start meeting pent up demand
Transformation of High-Performing Primary Care in Education
The UCSF Double Helix Curriculum:

15. Deciding on How Much Capacity to Reserve
Understand your data!
Transformation of High-Performing Primary Care in Education
The UCSF Double Helix Curriculum:
# of people who call today for an appointment
# of appointments per day

16. Communicating to Patients
Transformation of High-Performing Primary Care in Education
The UCSF Double Helix Curriculum:

17. Communicating to Staff
Role
Training
All Staff
Reason for this work in this clinic
Overview of the new model
How patients will be informed
Front Desk/ Schedulers
New scheduling guidelines
Communicating with patients about the changes (scripts)
Managing requests for appointments when there are no appointments left
Clinical Support Staff
Tracking patients who do not need follow up appointments
Communicating with patients about the changes
Managing requests for appointments when full
PCPs
Deciding who needs a follow up appointment
Communicating with patients about the schedule
Understanding scheduling data
Transformation of High-Performing Primary Care in Education
The UCSF Double Helix Curriculum:

18. The UCSF Double Helix Curriculum:
Key Principles
Bring the point at which supply and demand is balanced closer to today
Use the schedule for scheduling – not for tracking patients
Communicate, communicate, communicate – both to patients and to staff
Follow the data
Transformation of High-Performing Primary Care in Education
The UCSF Double Helix Curriculum:

19. The UCSF Double Helix Curriculum:
Evaluation
Transformation of High-Performing Primary Care in Education
The UCSF Double Helix Curriculum:
See evaluation sheet for thread objective