Program overview :

Optimizing Workflows to Deliver Standardized and Appropriate Virtual Care

First Nations Technical Services Advisory Group

The Alberta Indigenous Virtual Care Clinic provides essential virtual primary care services to individuals and families that self-identify as First Nations, Inuit and Métis. To enhance the patient and provider experience, the team has revamped existing workflows to optimize triaging and support for patients and healthcare professionals, resulting in nearly 9,000 patients receiving virtual care in a year. This initiative has involved all clinical staff, leading to a more consistent patient experience, improved provider satisfaction and standardized processes.

Objective and purpose of the promising practice 

The primary goal of this initiative was to address inconsistent communication and triaging between patients and medical office assistants, which led to varied patient experiences and an unstandardized approach to meeting patient and provider needs. The project focused on refining the booking process to ensure patients were matched with the most appropriate physicians within the clinic or directing patients to the most appropriate external service, thereby improving the overall effectiveness of care through revised triaging workflows.

Approach 

Engagement

The project team engaged extensively with diverse clinic staff to co-design new workflows. Through meetings, presentations, reports and weekly check-ins, project deliverables were collaboratively developed and piloted. Key partners included medical leads, clinical nurses, the clinic manager, medical office assistants and a patient navigator. Patient feedback was also collected through surveys and interviews to inform workflow design.

Outcomes

Between 1 February 2023 and 31 January 2024, the implementation of revised workflows has directly benefited almost 9,000 patients and involved all 46 clinic staff members. Notably, 73 percent of clinic patients reported not having a family doctor or nurse practitioner, and although the clinic does not provide family medicine, it has provided increased access to care for these patients until they are under the care of a local family doctor. Creation and sharing of the patient handbook allows the patients to have an understanding of services available and clearer expectations of the clinic. The standardized clinician workflow has resulted in improved communication between staff.

Impacts and learnings

Key takeaways 

• Assumptions that all clinics followed the same process led to varied patient experiences, underscoring the need for collective efforts with medical office assistants to regularly review and improve processes.
• External support and services should be utilized when necessary.
• Dedicated planning time is critical for successful improvements.
• Open communication and a clear implementation process are essential.

Facilitators

• The success of the project was driven by the evaluation team, the engagement of primary care physicians and medical office assistants and the support of project leads, the clinic manager, clinic coordinator and nurse.

Barriers

• Staff and provider experience varied.
• Availability of the team to meet was limited.
• Levels of change readiness among team members differed.
• Competing demands and priorities required significant time management.

The Alberta Indigenous Virtual Care Clinic’s initiative showcases the power of collaborative workflow redesign in enhancing access to care and standardizing patient experiences, ultimately leading to better outcomes for Indigenous communities.

For more information:

Michelle Hoeber, eHealth/Clinic manager
First Nations Technical Services Advisory Group (TSAG) 
mhoeber@tsag.net