Number of new patients/clients/enrolment

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Approximately 2.2 million Ontarians do not have a family physician. Escalating workforce shortages due to fewer graduates choosing family medicine, an aging workforce, and earlier retirement may cause an increase in the number of unattached patients to 3 million by 2025.

Although initiatives aimed at reducing administrative work for providers are important to support expanded access, access can also be measured at the practice level. The change ideas below present the fundamental principles of understanding patient panels, measuring supply and demand, and other examples of streamlining clinic workflows to expand capacity.

This indicator is intended to measure the net new number of patients/clients/enrolment, accounting for both patients that have left the practice, as well as newly added or enrolled patients.

Key resources

The College of Family Physicians of Canada’s Best Advice Guide: Panel Size provides guidance on factors affecting practice panel size
Information on the number of new clients for Alliance for Healthier Communities (AHC) community health centres can be found on page 25 of the AHC panel size handbook

Change Ideas

Determine ideal panel size based on caseload complexity and roster balance

Complete Panel Size Equation and Interpretation
Section 4.2 of the Advanced Access and Efficiency Workbook for Primary Care by Health Quality Ontario
Refer to MyPractice: Primary Care physician and group reports
Provides SAMI score to better understand practice complexity and expected resource use

Implement key approaches outlined in the Advanced Access and Efficiency Workbook for Primary Care to assist with providing timely access to appointments

Measure and balance supply and demand
Review Sections 2.1 through 2.3 of the Advanced Access and Efficiency Workbook for Primary Care by Health Quality Ontario
Measure and reduce backlog
Process measure: Percentage of future appointments that are “good backlog” versus “bad backlog”
Review Section 2.5 of the Advanced Access and Efficiency Workbook for Primary Care by Health Quality Ontario

Consider innovative appointment types and approaches to help manage demand for appointments

Test new digital workflows to streamline appointment booking and manage demand
Explore online appointment booking and related change management support from the eHealth Centre of Excellence
Support patients and their caregivers to self-manage chronic conditions
Refer patients to regional self-management programs
Manage demand for mental health services through trial of a rapid assessment model
Refer to pages 10–13 of Innovation in Primary Care: Integrating mental health services in primary care for an example of an innovative integrated care model