Identifying Successful Practices to Overcome Access to Care Challenges in Community Health Centers

Background: Despite health care access challenges among underserved populations, patients, providers, and staff at community health clinics (CHCs) have developed practices to overcome limited access. These “positive deviant” practices translate into organizational policies to improve health care acc...

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Main Authors: Tammy Toscos, Maria Carpenter, Mindy Flanagan, Kislaya Kunjan, Bradley N. Doebbeling
Format: Article
Language:English
Published: SAGE Publishing 2018-02-01
Series:Health Services Research & Managerial Epidemiology
Online Access:https://doi.org/10.1177/2333392817743406
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author Tammy Toscos
Maria Carpenter
Mindy Flanagan
Kislaya Kunjan
Bradley N. Doebbeling
author_facet Tammy Toscos
Maria Carpenter
Mindy Flanagan
Kislaya Kunjan
Bradley N. Doebbeling
author_sort Tammy Toscos
collection DOAJ
description Background: Despite health care access challenges among underserved populations, patients, providers, and staff at community health clinics (CHCs) have developed practices to overcome limited access. These “positive deviant” practices translate into organizational policies to improve health care access and patient experience. Objective: To identify effective practices to improve access to health care for low-income, uninsured or underinsured, and minority adults and their families. Participants: Seven CHC systems, involving over 40 clinics, distributed across one midwestern state in the United States. Methods: Ninety-two key informants, comprised of CHC patients (42%) and clinic staff (53%), participated in semi-structured interviews. Interview transcripts were subjected to thematic analysis to identify patient-centered solutions for managing access challenges to primary care for underserved populations. Transcripts were coded using qualitative analytic software. Results: Practices to improve access to care included addressing illiteracy and low health literacy, identifying cost-effective resources, expanding care offerings, enhancing the patient–provider relationship, and cultivating a culture of teamwork and customer service. Helping patients find the least expensive options for transportation, insurance, and medication was the most compelling patient-centered strategy. Appointment reminders and confirmation of patient plans for transportation to appointments reduced no-show rates. Conclusion: We identified nearly 35 practices for improving health care access. These were all patient-centric, uncovered by both clinic staff and patients who had successfully navigated the health care system to improve access.
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spelling doaj.art-703ca19caabb498ab87bcbfdfd0bb41c2022-12-21T23:41:24ZengSAGE PublishingHealth Services Research & Managerial Epidemiology2333-39282018-02-01510.1177/2333392817743406Identifying Successful Practices to Overcome Access to Care Challenges in Community Health CentersTammy ToscosMaria CarpenterMindy FlanaganKislaya KunjanBradley N. DoebbelingBackground: Despite health care access challenges among underserved populations, patients, providers, and staff at community health clinics (CHCs) have developed practices to overcome limited access. These “positive deviant” practices translate into organizational policies to improve health care access and patient experience. Objective: To identify effective practices to improve access to health care for low-income, uninsured or underinsured, and minority adults and their families. Participants: Seven CHC systems, involving over 40 clinics, distributed across one midwestern state in the United States. Methods: Ninety-two key informants, comprised of CHC patients (42%) and clinic staff (53%), participated in semi-structured interviews. Interview transcripts were subjected to thematic analysis to identify patient-centered solutions for managing access challenges to primary care for underserved populations. Transcripts were coded using qualitative analytic software. Results: Practices to improve access to care included addressing illiteracy and low health literacy, identifying cost-effective resources, expanding care offerings, enhancing the patient–provider relationship, and cultivating a culture of teamwork and customer service. Helping patients find the least expensive options for transportation, insurance, and medication was the most compelling patient-centered strategy. Appointment reminders and confirmation of patient plans for transportation to appointments reduced no-show rates. Conclusion: We identified nearly 35 practices for improving health care access. These were all patient-centric, uncovered by both clinic staff and patients who had successfully navigated the health care system to improve access.https://doi.org/10.1177/2333392817743406
spellingShingle Tammy Toscos
Maria Carpenter
Mindy Flanagan
Kislaya Kunjan
Bradley N. Doebbeling
Identifying Successful Practices to Overcome Access to Care Challenges in Community Health Centers
Health Services Research & Managerial Epidemiology
title Identifying Successful Practices to Overcome Access to Care Challenges in Community Health Centers
title_full Identifying Successful Practices to Overcome Access to Care Challenges in Community Health Centers
title_fullStr Identifying Successful Practices to Overcome Access to Care Challenges in Community Health Centers
title_full_unstemmed Identifying Successful Practices to Overcome Access to Care Challenges in Community Health Centers
title_short Identifying Successful Practices to Overcome Access to Care Challenges in Community Health Centers
title_sort identifying successful practices to overcome access to care challenges in community health centers
url https://doi.org/10.1177/2333392817743406
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