Implement: Barriers & Mitigation Strategies | DAC-SP Early Detection Blueprint

Patient drop-off after assessment or diagnosis.

Complexities within the healthcare system may create obstacles to patients receiving necessary follow-up testing and care.

HOW THIS BARRIER MIGHT TAKE PLACE:

Long wait times for follow-up appointments.
Patients not scheduling or showing up to follow-up appointments.
Potential challenges for patients getting to the clinic due to inconvenient locations or a lack of accessible transportation.

Mitigation Strategy

Improve system access for timely follow-up care

Reducing patient drop-off requires optimized workflows and identifying opportunities for logistical support. Aim to enhance patient access and promote prompt and effective delivery of care beyond their initial visit.

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Tactics include

Creating workflows and site capabilities to combine services into fewer appointments.
Scheduling patients for follow-up care during their visit and sending reminders to patients about upcoming appointments.
Offering flexible clinic hours to improve scheduling options for patients.
Facilitating accessible transportation to the clinic for patients in need (this may involve partnering with an external organization).
Providing a patient survey to uncover obstacles to accessing follow-up care

Staff turnover.

Both project and care teams may experience staff turnover throughout the program planning and implementation. The loss of dedicated leaders, champions, and other staff may reduce the program’s momentum and/or potentially impact its sustainability.

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HOW THIS BARRIER MIGHT TAKE PLACE:

Shifting requirements for workforce staffing, training, and education in response to evolving staffing needs.
Difficulty ensuring training materials are available and accessible for new team members.
Staff turnover that requires new onboarding and re-training.
Staff turnover and no local leadership leading to a loss of knowledge and momentum.

Mitigation Strategy

Provide clearly documented job descriptions and a succession plan

Challenges regarding staffing turnover can be mitigated by well-documented roles and responsibilities for everyone involved. To ensure program progress and continuity, clearly outline any transitions across the team, and create a succession plan whenever possible.

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Tactics include

Creating a swimlane diagram (across-functional flowchart) to inform the roles and transitions, including what training needs to be deployed and for whom.
Ensuring the training materials are developed by the leads/experts in the various work streams with a clear audience and objectives in mind.
Ensuring the training materials are accessible when needed.
Having new team members "job shadow" an experienced person doing the task.
Developing workflow “how to” videos documenting the step-by-step processes.

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Integrating the new workflow into the physical and technological environment.

Clinics may face challenges as they introduce new diagnostics assessments and technology. This relates to a range of logistical set up challenges, from how the physical clinic space is set up to how patient data is shared between departments.

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HOW THIS BARRIER MIGHT TAKE PLACE:

Challenges in figuring out the logistics for dedicated space and environmental requirements (e.g., flat surface, quiet, well-lit, private).
Convincing providers to switch from their existing tools (from paper to digital, if planning to use a digital assessment) and integrating the workflow into the broader healthcare system technological environment.
Planning for digital cognitive assessment tools’ software and hardware upkeep, charging, secure storage.

Mitigation Strategy

Assess the clinic environment for potential issues and plan for workflow iterations

Proactive and thorough planning can help mitigate many of the physical and technological workflow integration challenges. Efforts should be made to ensure the compatibility and logistical requirements are addressed early on with an established feedback loop to facilitate improvements.

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Tactics Include

Creating user-friendly process flow charts to help guide involved clinicians through the transition.
Collaborating with providers and staff to advise the design of the workflow integration.
If using a digital cognitive assessment, creating a checklist for ongoing maintenance activities, including daily checks for hardware and software and more in-depth audits at longer intervals.
Testing the workflow and gain feedback from clinicians and patients; adjust the process based on findings.
Having a strong monitoring and evaluation process to ensure issues are quickly caught and resolved.

Barriers & Mitigation Strategies

Integrating the new workflow into the physical and technological environment.

Staff turnover.

Patient drop-off after assessment or diagnosis.

Patient drop-off after assessment or diagnosis.

HOW THIS BARRIER MIGHT TAKE PLACE:

Mitigation Strategy

Improve system access for timely follow-up care

Tactics include

Staff turnover.

HOW THIS BARRIER MIGHT TAKE PLACE:

Mitigation Strategy

Provide clearly documented job descriptions and a succession plan

Tactics include

Integrating the new workflow into the physical and technological environment.

HOW THIS BARRIER MIGHT TAKE PLACE:

Mitigation Strategy

Assess the clinic environment for potential issues and plan for workflow iterations

Tactics Include

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