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Table 1 The key principles of advanced access, adapted from Murray & Berwick (2003) [6], Breton et al. (2017) [7]

From: Changing nursing practice within primary health care innovations: the case of advanced access model

Key principles of Advanced Access Definition
1 Balance supply and demand To assess and understand, on the one hand, the actual patient demand for appointments per physician/health professional per day, weighted by the patients’ status and, on the other hand, the supply (e.g., number of appointments offered), in order to achieve the right balance between the two, matching demand with supply. Strategies to decrease demand for visits (e.g., max pack, extending visit intervals) or to increase supply (e.g., redesigning doctor/health professional scheduling systems) are used.
2 Reduce the backlog of previously scheduled appointments To eliminate previously scheduled appointments (wait list) through many strategies, such as adding resources or increasing the supply of visits during a period of time. A communication strategy must also be put in place to inform and educate patients about the new advanced access model.
3 Review the appointment system To plan physicians’ (health professionals such as nurses) schedules over a short term (two to four weeks) and smooth out the demand for visits in order to offer same-day appointments for acute and urgent cases or quick appointments according to patients’ needs.
4 Integrate inter-professional practice To develop or enhance inter-professional collaborative practice between physicians and other healthcare providers (e.g., nurses). Professional roles need to be optimized and tasks need to be clarified to respond to patient needs in a timely manner.
5 Develop contingency plans To plan for seasonal increases in demand and to develop coverage plans for replacing medical staff or other healthcare providers during vacation and sick leave. Many strategies are applied, such as increasing the number of slots prior to leave and after returning to duty, hiring temporary providers, and distributing and matching staffing competencies to demand. Integrating collaborative and interdisciplinary practice facilitates planning for periods of absence.