Patient-Centered Access and Continuity (AC)
Regional Collaborative 10.12.17Corinne Torgesen
AC-01 (Core)Assesses the access needs and preferences of the patient population
Guidance:-The practice evaluates patient access from collected data (i.e., survey, patient interviews, comment box) to determine if existing access methods are sufficient for its population.
Evidence:-Documented processANDEvidence of Implementation.*This is separate from the patient satisfaction survey in QI-04 (Core) becauseAC-01 focuseson access.*
AC-02 (Core)Provides same-day appointments for routine and urgent care to meet identified patient needs
Guidance:- Practice reserves time on daily appointment schedule to accommodate patient requests for a same-day appointment for routine or urgent care needs.*Time frames allocated for these appointment types aredetermined by the practiceand based on patient needs.*
Evidence:Documented processANDEvidence of implementation.The report may include a 5-day schedule to demonstrate the appointments are availableORa report showing which same-day appointments were used.
AC-03 (Core)Provides routine and urgent appointments outside regular business hours to meet identified patient needs
Guidance:- Practice offers routine and urgent careappointmentsoutside typical business hours.-For example, a practice may open for appointments at 7 a.m. or remain open until 8 p.m. on certain days or open on alternating Saturdays.
Evidence:- Documented processANDEvidence of Implementation.-ThisDOES NOTinclude:Offeringappts. when the practice would otherwise be closed for lunchDaytimeappts. when practice would otherwise close early (Friday afternoon, holidays, etc.)Utilizing ER or urgent care facility that is unaffiliated with the practice.
AC-04 (Core)Provides timely clinical advice by telephone
Guidance:-Patients can call the practice any time of the day or night and receive interactive clinical advice.-Clinicians return calls in a time frame determined by the practice.Clinical advice must be provided by qualified staff, but can be communicated by any team member.-Instructing patients to call 911 when the office is closed is insufficient.
Evidence:-Documented processANDreport-NCQA reviews a report summarizing the practice’s expected response times and how it monitors its performance of those standards.-Practice submits data on at least 7 days of such calls.
AC-05 (Core)Documents clinical advice in patient records and confirms after-hours advice does not conflict with patient medical record
Guidance:- Practice documents all clinical advice in the patient record, whether it is provided by phone or be secure electronic message during office hours and when the office is closed.
Evidence:Documented processANDEvidence of implementationEvidence includes two examples of documenting the clinical advice (1 during office hours and 1 after normal business hours as defined in AC-03).
AC-10 (Core):Helps patients/families/caregivers select or change a personal clinician
Guidance:Giving patients a choice of clinician emphasizes the importance of the ongoing patient-clinician relationship.The practice documents patients’ choice of clinician.Practice Teams can also be selected for the primary care option.
Evidence:Documented process*Clinics with a single clinician automatically meet this criteria.*
AC-11 (Core):Sets goals and monitors percentage of patient visits with the selected clinician or team
Guidance:-The practice establishes a goalfor the proportion of visits a patient should have with the primary care provider and care team.*The goal should acknowledge that meeting patient preferences for timely appointments will sometimes be at odds with the ability to see their selected clinician.*