"AIM was a success! Overall access improved, clerical staff is now scheduling patients (versus the nurses) and offices are re-arranged to decrease the disruptions, increase space and ease the finding of materials."
--The Northern Alberta Cardiac Rehabilitation Program, Edmonton, Alberta
"AIM provides the family physician team with a step-by-step approach that can result in significant change for the healthcare team and system, but most importantly, improves the health of our patients."
--Sheri Fielding, nurse practitioner, Heritage Medical Clinic, Edmonton, Alberta
In this section, you'll learn about the Alberta AIM program, why AIM can help healthcare teams improve patient care and face the challenges of our healthcare system, how the program works, the time commitment and the history of how AIM was created in Alberta.
Alberta AIM helps physicians, specialists and healthcare teams see their patients sooner and reduce wait times while patients are at their appointment.
Healthcare teams that have been through AIM report better patient access, increased practice efficiency, smooth flow of work, higher morale, the ability to take on more patients, increased revenue and, most importantly, better and more comprehensive patient care. See Alberta AIM results.
AIM is built on a collaborative learning model, based on the work of Mark Murray and Associate's program that includes face-to-face learning sessions, written reports, phone calls and clinic support from AIM Facilitators and resource staff. Teams work together with others to test new models of service delivery and share best practices.
Measurement is the foundation of AIM so that participants can accurately identify bottlenecks and challenges in their own practice, and better manage their patient demand with supply. Learn more about measurement.
There is no cost to enrol in Alberta AIM. Participation is supported by a grant from Alberta Health.
AIM is largely based on the work of Dr. Mark Murray, the lead Faculty member for Alberta AIM and principal of Mark Murray & Associates of California.
Click below to view videos of Dr. Murray discussing history, change and gravity.
Fact: Alberta's healthcare system is plagued by delays to get an appointment with a physician, extended waits during an appointment and repeated phone calls to get a test result or question answered.
Fact: About 18% of Albertans don't have a family physician. Yet research shows that patients who have an ongoing relationship with a physician do better.
Fact: Emergency rooms across Alberta are overcrowded as too many patients use them in place of seeing a family physician.
Fact: Alberta physicians, specialists and health programs have waiting lists that exceed provincial standards.
These factors hurt health outcomes, patient satisfaction and cost. But there is a proven process and set of principles that will help practices and program reduce waiting times without adding costly resources.
Because each practice is different, there is no prescribed action plan to create a high quality health system, but there are similarities found by those who have been successful in making improvements:
Patients who have a relationship with a physician (and/or healthcare team) receive better clinical care than those who do not.
Patients who do not have to wait for services are healthier than those who are forced to wait.
High quality clinical care is a function of reliability and predictability within a physician practice or health program.
A team approach to care yields improved patient outcomes.
A culture of improvement creates and sustains exceptional clinical care.
AIM helps physicians and healthcare teams apply these principles to their own practices, in their own way, to improve their ability to see patients in a timely manner, provide effective and efficient care, and improve health outcomes.
When you sign up with Alberta AIM, you will be assigned to a "collaborative," which consists of other participating healthcare teams. We use this term because AIM works through a collaborative model of learning. Physicians and their teams work collectively with other participating teams to apply improvement principles in their own practices, guided by expert faculty.
During the AIM collaborative, teams apply the following processes:
Team: Form a team. Improvement teams are made up of members who represent all key roles in the clinic/program. This reinforces the concept that "those who do the work must change the work."
Aim: Set specific, measurable goals for access and office efficiency and, later, for clinical care.
Map: Build a flow map to understand all the elements of a patient's visit through the office, and identify where challenges and constraints exist.
Measure: Collect and analyze data to understand system performance and, later, to assess the impact of changes, ie, whether changes have resulted in authentic improvements. Ongoing measurement is essential to improve and maintain top system performance.
Change: Tests of change are applied using The Model for Improvement PDSA (Plan-Do-Study-Act) cycles.
Sustain/Spread: Sustain the gains, celebrate success and spread a culture of improvement throughout the clinic and larger team or system.
An Alberta AIM collaborative takes place over the course of 8 to 12 months. The AIM learning model involves a pre-work phase, five, face-to-face learning sessions of about two days each, and action periods between each learning session.
There are five learning sessions of about two days each where all members of the collaborative meet face-to-face with faculty and facilitators in plenary sessions, small group discussions and team meetings.
These are the major integrative events of the AIM process that give attendees the opportunity to learn about various aspects of improving office-based care.
During these sessions, attendees will:
Learn from faculty and colleagues
Gather new information on process improvement
Receive individual coaching from faculty
Share information and collaborate on improvement plans
Develop action plans to improve access and office efficiency
To learn more about the content of each learning session, click here.
In between each learning session is an "action period" where measurement tools are implemented and changes to the practice are tested and evaluated.
Although teams focus on their own practices during the action periods, they remain in contact with other participants and faculty through written monthly reports, conference calls and group emails.
Teams are supported by a network of colleagues, including current participants, AIM alumni, facilitators and faculty, as well as library and measurement support teams.
Each clinical team is assigned an AIM facilitator to work with them throughout the AIM collaborative process. They meet with clinics regularly and act as change agents to help teams in their improvement efforts. Facilitators are often provided as "in kind" contributions from AIM stakeholder groups. They have backgrounds as quality improvement leaders, healthcare providers and other leadership roles within the healthcare community.
History of Alberta AIM
Alberta AIM began in 2005, when the Chinook Primary Care Network engaged in a two-year collaborative initiative with Dr. Mark Murray and Dr. Mike Davies to improve the efficiency of family practice teams and reduce patient wait times.
Murray, a family physician, is principal of Mark Murray & Associates, a healthcare consulting group in Sacramento, California. A faculty member of the Institute for Healthcare Improvement (IHI), he has served as chair of the IHI's Breakthrough Series Collaboratives on Reducing Delays and Waiting Times and has worked with diverse medical groups in Canada, the United States and abroad.
Davies, a general internist and chief of staff at the Veteran Administration Black Hills Health Care System, in Fort Meade, South Carolina, has been involved in improving access in that organization as well as numerous groups in the United States.
Healthcare teams in the Chinook Primary Care Network went through the program from 2005-2007 with strong results in improving efficiency, wait times and patient care.
In 2007, it was decided to build a made in Alberta version of AIM, based on the work of Mark Murray & Associate's program, and spread it across the province. Alberta AIM was founded with funding from Alberta Health, Alberta Health Services, the Alberta Medical Association, the Primary Care Initiative program and Toward Optimized Practice (TOP).
Alberta AIM is based largely on the work of Mark Murray & Associates and uses the Institute for Healthcare Improvement's Break Through Series model. AIM concepts are also based on a number of improvement theories and methodologies including The Model for Improvement, developed by the Associates in Process Improvement, Demming's System of Profound Knowledge, Queuing Theory, Theory of Constraints and LEAN.
Since 2007, hundreds of primary care, specialty care and regional program teams have participated in Alberta AIM. More than 85% of them say patient access has since improved.