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Patient Wait Times
The IHS has established standards for patient wait times for primary care and urgent care visits in Indian Health Service Direct Care Facilities to improve the quality and experience of care.
Background: The mission of the Indian Health Service is to raise the physical, mental, social, and spiritual health of American Indians and Alaska Natives to the highest level. Quality of care is an agency priority, and IHS is committed to continuing our efforts to assure a high-performing health care delivery system for American Indian and Alaska Native people. In April 2016, the Government Accountability Office (GAO) recommended that IHS communicate specific agency-wide standards for wait times, monitor wait times in federal facilities, and take corrective actions when standards are not met.
The IHS circular on Wait Times Standards for Primary and Urgent Care Visits in the Indian Health Service Direct Care Facilities is the result of a collaborative process that reflects input from a diverse group of subject matter experts within IHS. IHS reported the approval and publication of its Patient Wait Times standard to GAO in September 2017 resulting in GAO closing the recommendation for development of standards.
Standards Development: The IHS examined current standards, practices, and improvement efforts in IHS, identified gaps and areas for improvement, benchmarked against “industry” standards, and reviewed best and innovative practices. Factors that influence wait times and patient and staff perspectives were also taken into account. A strategic decision was made to focus on primary care and urgent care visits standards initially and develop others standards (e.g. Emergency Department Wait Times) at a future time. Draft standards were reviewed and revised through an iterative process by subject matter experts in IHS. The IHS Acting Director approved the IHS Circular on Wait Time Standards for Primary and Urgent Care Visits in Indian Health Service Direct Care Facilities on August 25, 2017.
- Mean Appointment Wait Time for Primary Care of 28 days or less
- Mean Appointment Wait Time for Urgent Care of 48 hours or less
Standards Implementation and Monitoring: Implementation of the standards will be overseen by the IHS Improving Patient Care Program which promotes application of quality improvement methods. IHS is targeting the full implementation of Agency-wide standards for wait times by December 31, 2017, including monitoring of the outcome data. Some service units may already have the capability to measure and report progress. However, other service units may need assistance. Therefore, it is understood and expected that the standards may not be met immediately at some sites. The Improving Patient Care program will provide resources, tools and technical assistance to service units to support the implementation of the wait time standard. Progress toward meeting these standards will be reported on a regular basis to the IHS National Accountability Dashboard for Quality.
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