Masset Clinic: Enhancing access to primary care on Haida Gwaii

Timely access to medical appointments in a family practice setting is an essential element of delivering patient-centered care. Masset Clinic, on Haida Gwaii, has experienced capacity challenges due to a variety of factors such as the large patient panel and too few physicians to complex needs and people simply not showing up to appointments.

A new physician began working at the clinic in spring 2022, and as their panel of patients was unfamiliar to them, they needed to change their appointments from 20 minutes to 30 minutes to provide quality care. This meant that last fall, the next available appointment for pre-booking was almost 47 days away for a typical patient.

This experience prompted the clinic to reach out to the Family Practice Services Committee’s (FPSC) Practice Support Program (PSP) for support. They worked together with the physicians at the clinic in late 2022 to reduce appointment wait times, improving access to care for people living in this remote community. Denise Cerqueira-Pages, the Practice Support Coach for the area, worked with the clinic team to implement quality improvement changes that decreased clinic appointment delays. From the end of September to the end of October 2022, the wait time for an appointment to see a family physician dropped from 47 days to 24. By December 2022, the wait time for an in-person visit was 16 days, and just 9 for a virtual visit.

For Cerqueira-Pages, it was important to evaluate the supply and demand for appointments at the clinic with the staff by using the practice improvement tools in her toolbox as a coach. She adds that providing excellent care was the uniting mission. “The entire team all had the same goal,” she says.

They monitored and assessed appointment needs and availability and tackled the existing backlog. By continuously making changes and looking at the data, it resulted in a major decline in wait times for a family doctor’s appointment.

In this rural community, the emergency department (ED) at Northern Haida Gwaii Hospital (which is on the same site as the Masset Clinic) is under immense pressure. By making the primary care system more efficient, it reduces the stress on the local ED, says Cerqueira-Pages. She said, “If patients cannot have access to the clinic, they’re going to go to the emergency, and we see this happen a lot.”

Working together to enhance patient access to appointments has had a positive effect on the entire clinic team in this tight-knit locality, Cerqueira-Pages notes. “This work benefits everybody. It’s a good experience for physicians, so they don’t feel worried about their end of care. For primary care assistants, they are the front of the clinic, and they really like that patients can call the clinic and book an appointment in a timelier way.”

This kind of quality improvement work can be done across BC, Cerqueira-Pages says, “We can use the different PSP tools and efficiency guides to advance patient access. For this kind of project, we can work together. It’s a challenge, but it’s possible.”