JOURNAL OF AMBULATORY CARE MANAGEMENT最新文献

{"title":"From the Editors: Adapting Under Pressure: Access, Technology, and the Ambulatory Workforce.","authors":"E Lee Rosenthal, Durrell J Fox, Kimberley H Geissler","doi":"10.1097/JAC.0000000000000570","DOIUrl":"10.1097/JAC.0000000000000570","url":null,"abstract":"","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":" ","pages":"E175-E176"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148833480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Equity in Access to Appointments: Impact of Spanish-Language Fast Pass Messaging in an Academic Health System.","authors":"Jennifer Grob, Jasmine Navar, Hillary Lopez, Mariah Bishop, Ross Reynolds, Jordan Moore, Ivan E Porter","doi":"10.1097/JAC.0000000000000573","DOIUrl":"https://doi.org/10.1097/JAC.0000000000000573","url":null,"abstract":"<p><strong>Objective: </strong>Patients with limited English proficiency often face barriers to accessing timely care. We evaluated whether Spanish-language Fast Pass messaging, combined with two-way Short Message Service (SMS) functionality, increased appointment acceptance rates among Spanish-preferring patients while maintaining equitable outcomes for English-preferring patients.</p><p><strong>Methods: </strong>A pre/post-quality improvement project was conducted at Mayo Clinic from November 2023 to June 2025. Epic's Fast Pass, an automated appointment waitlist system, was enhanced with Spanish-language templates and bidirectional SMS in lieu of patient portal utilization. The primary outcome was the Fast Pass acceptance rate for Spanish-preferring patients. Balancing measures included acceptance among English-preferring patients. Secondary outcomes included scheduler efficiency and cost savings.</p><p><strong>Results: </strong>Prior to implementation, Spanish-preferring patients accepted 4.69% of Fast Pass offers compared with 7.57% for English-preferring patients. Post-implementation, acceptance rates for Spanish-preferring patients increased from 4.69% to 8.05%, a 71.6% improvement in the acceptance rate, exceeding the initial target of a 7.57% acceptance rate. Acceptance rates for English-preferring patients also improved, rising from 7.57% to 9.5%, or a 25.5% improvement in the acceptance rate. The intervention resulted in 344 additional Spanish-language accepted appointments and 29,883 additional English-language accepted appointments, both measured by unique patient appointments. The intervention also improved operational efficiency, saving more than 4,000 hours of scheduler time and reducing scheduling-related costs.</p><p><strong>Conclusions: </strong>Spanish-language concordant and SMS-enabled Fast Pass messages improved patient equity in appointment access while increasing scheduling efficiency and reducing operational costs. Health systems should adopt language-concordant digital communication strategies. Future research should expand to include additional languages and explore artifical intelligence-based scheduling support.</p>","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Advanced Practice Provider Roles Through Standard Patient Contact Hours: Improving Patient Access and Workforce Sustainability.","authors":"Jamie Silkey, Jennifer Mahaffey, Arthi Susai, Ashleigh Kervel, Kimberly S Gecsi","doi":"10.1097/JAC.0000000000000574","DOIUrl":"https://doi.org/10.1097/JAC.0000000000000574","url":null,"abstract":"<p><strong>Objective: </strong>To assess changes in patient access, productivity, financial performance, and workforce outcomes before and after the implementation of standardized clinic workweek expectations for advanced practice providers (APPs), inclusive of physician assistants and nurse practitioners, in ambulatory specialty care. The initiative established 36 patient-facing hours per week for a full-time APP and included redesigning workflows and care team responsibilities.</p><p><strong>Methods: </strong>A multidisciplinary team approach was used to optimize clinical operations and support APP sustainability. Interventions included assessing workload and identifying barriers. The use of protocols, pathways, and reallocating nonclinical tasks allowed a focus on patient-facing efforts. Alignment of template scheduling and standard unavailable times helped to launch a dashboard that monitored percent compliance with clinical workweek expectations. An APP job architecture using an ambulatory playbook and expected hours template was developed. Workflows were enhanced by looking at total care team growth needs. Key opportunities include reducing electronic burden and developing new pathways for complex triage and medical record review. Access, productivity, financial, and workforce outcomes were evaluated descriptively from fiscal year 2023 through fiscal year 2025 as part of a quality improvement initiative.</p><p><strong>Findings: </strong>Between fiscal year 2023 and fiscal year 2024, among 2,018,479 patient encounters and across 17 medical and surgical specialties, patient experience scores for \"ability to get an appointment\" improved from 68.5% to 70%, rising from the 63rd to the 69th percentile. Overall patient visits increased 6.2%; APPs accounted for 77% of visit growth. New patient visits increased 4.5% with a 16.8% increase in APP new visits. APP work Relative Value Unit (wRVU) increased 20%, a 24% increase in total payments. APP engagement scores increased from the 47th to the 56th percentile.</p><p><strong>Conclusion: </strong>Improvements in patient access, APP productivity, and financial performance, along with APP engagement, were observed by establishing clear job standards, addressing barriers that impeded patient care, and redistributing workflows. Continued evaluation is needed to determine the sustainability of these changes and further opportunities for specialty care teams.</p>","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148983816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multicomponent Operational Strategies to Support Follow-up Attendance in Child and Adolescent Psychiatry: A Longitudinal Evaluation.","authors":"Ayman Saleh, Marc DiFazio, Adelaid Robb","doi":"10.1097/JAC.0000000000000572","DOIUrl":"https://doi.org/10.1097/JAC.0000000000000572","url":null,"abstract":"<p><strong>Background: </strong>Missed follow-up appointments disrupt continuity of care and leave scarce outpatient psychiatric capacity underutilized.</p><p><strong>Objective: </strong>To evaluate longitudinal changes in follow-up missed appointment rates (MAR) associated with operational strategies implemented in a child and adolescent psychiatry outpatient clinic.</p><p><strong>Methods: </strong>We conducted a retrospective observational study using monthly data from July 2018 through December 2022. The intervention included telehealth expansion, implementation of the attendance engagement framework (AEF), and communication enhancements. Segmented interrupted time-series regression evaluated monthly follow-up MAR while accounting for time, the COVID-19 period, telehealth utilization, and AEF level and slope changes. An exploratory linear trend analysis evaluated phone abandoned call rates.</p><p><strong>Results: </strong>The analysis included 54 months and 53,507 scheduled follow-up appointments. Monthly MAR declined from 12.0% in July 2018 to 6.0% in December 2022. Telehealth visits had lower MAR than in-person visits (5.6% vs. 11.1%, p < .001). The monthly slope decreased after March 2020 relative to the preceding trend (B = -0.005, 95% confidence interval [CI], -0.006 to -0.003; p < .001). Greater telehealth utilization was associated with lower monthly MAR (B = -0.112, 95% CI, -0.155 to -0.069; p < .001), corresponding to an estimated 1.1 percentage point lower MAR for each 10 percentage point increase in telehealth utilization. AEF implementation was not associated with a significant immediate level change (B = -0.020, 95% CI, -0.044 to 0.003; p = .091). The post-AEF slope changed significantly (B = 0.003, 95% CI, 0.001-0.005; p = .003), indicating that rates continued to decline, although more slowly. Phone abandoned call rates decreased from 50% to 2%.</p><p><strong>Conclusion: </strong>The multicomponent intervention was associated with sustained improvement in follow-up attendance. Flexible hybrid care, supportive attendance engagement, and reliable communication systems may help clinics use limited capacity more efficiently. Future evaluations should examine patient-level outcomes and equity.</p>","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterizing Energy Insecurity: Utility Shut-Off Protection Requests in Pediatric Primary Care.","authors":"Nicole C de Paz, Clement J Bottino, Corinna J Rea, Snehal N Shah","doi":"10.1097/JAC.0000000000000555","DOIUrl":"10.1097/JAC.0000000000000555","url":null,"abstract":"<p><strong>Background: </strong>Household energy insecurity is increasingly recognized as an important social determinant of health, affecting over a third of American households. Utility shut-off protection letters from medical providers are an important but imperfect tool to address acute energy insecurity, and their use has not yet been explored in the pediatric literature.</p><p><strong>Objective: </strong>We aimed to characterize utility shut-off protection letter requests in a pediatric primary care population and to identify potential predictors of utility letter requests.</p><p><strong>Methods: </strong>This was a retrospective, case-control study utilizing secondary data from electronic health records and administrative data from a large, hospital-based primary care clinic located in Boston, Massachusetts.</p><p><strong>Results: </strong>During 2018 and 2019, the families of 704 patients made 1,694 utility letter requests; of those, 57% made a repeat letter request. In multivariable analysis between cases ( n = 704) and controls ( n = 704), public insurance, younger age, Black race or Hispanic ethnicity, and attending a well-child visit were positively associated with utility letter requests. A negative association was found with lower medical complexity and non-English preferred language.</p><p><strong>Conclusions: </strong>Utility shut-off protection letters were requested more frequently by families with public insurance and those with Black and Hispanic children, consistent with national studies of energy insecurity. Less frequent letter requests by non-English speaking families raise concerns for inequitable access to letters, and the finding of frequent repeat requests underscores the often-chronic nature of energy insecurity. These findings highlight the need for more equitable and sustainable approaches to energy insecurity within pediatric primary care and exploration of policy interventions, such as common applications for Medicaid and energy assistance programs, to support those at high risk for energy insecurity.</p>","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":" ","pages":"E150-E160"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association Between Federally Qualified Health Centers' Payer Mix and Clinical Outcomes Pre- and Post-COVID-19.","authors":"Devdutt Upadhye, Mohammed Alzeen, Dilorom Zuparova, Philip Cendoma, Nancy Borkowski","doi":"10.1097/JAC.0000000000000556","DOIUrl":"10.1097/JAC.0000000000000556","url":null,"abstract":"<p><strong>Objective: </strong>Federally Qualified Health Centers (FQHCs) serve as critical safety net providers for over 30 million patients annually, operating with diverse payer mixes that create unique financial and operational challenges. This study examined associations between payer mix patterns and clinical quality outcomes in FQHCs, comparing relationships between 2019 and 2022 to capture COVID-19-related coverage transitions.</p><p><strong>Methods: </strong>Using Resource Dependence Theory, we conducted a repeated cross-sectional analysis of Uniform Data System data from 1,190 FQHCs in 2019 and 1,150 FQHCs in 2022, examining eight clinical quality measures before (2019) and after (2022) the pandemic-driven coverage shifts. Multiple linear regression models with state-clustered robust standard errors assessed associations between payer mix proportions (Medicaid, Medicare, uninsured, with private insurance as reference) and quality performance, controlling for organizational characteristics.</p><p><strong>Results: </strong>Results revealed complex, evolving relationships between payer mix and quality. In 2019, a 10 percentage point (pp) increase in Medicaid proportion was associated with lower performance on tobacco screening (-1.64 pp, p =.004), statin therapy (-1.43 pp, p = .014), and colorectal screening (-1.91 pp, p = .010). By 2022, tobacco screening associations reversed, with Medicaid (0.94 pp, p = .023) and uninsured (1.35 pp, p = .009) populations showing better performance than the privately insured. For outcome measures, higher proportions of Medicaid and uninsured patients were consistently associated with more patients with uncontrolled diabetes across both years, while higher Medicare proportions were associated with fewer patients with uncontrolled diabetes. Larger FQHCs showed better performance on process measures, while rural location was associated with lower cervical cancer screening rates but better hypertension control.</p><p><strong>Conclusions: </strong>These findings suggest that payer mix associations with quality are neither uniform nor stable over time, challenging assumptions about resource munificence and organizational performance in safety net settings. Policymakers should consider the dynamic nature of payer mix associations when designing payment models and quality improvement initiatives for FQHCs.</p>","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":"49 3","pages":"E137-E149"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148212805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"To Get the Patient the Best Care\": A Qualitative Analysis of Community Health Worker Integration in North Carolina Federally Qualified Health Centers.","authors":"Amy Kryston, Emma J Boyce, Melinda Gomez, Nicolle Miller, Devin T Worster","doi":"10.1097/JAC.0000000000000559","DOIUrl":"10.1097/JAC.0000000000000559","url":null,"abstract":"<p><strong>Objective: </strong>Research suggests that community health worker (CHW) integration within clinical care teams can improve chronic disease outcomes and address health-related social needs. However, the processes by which CHWs are integrated in Federally Qualified Health Centers (FQHCs) and organizational factors enabling their success remain incompletely understood. Within the context of a national initiative sponsored by the Centers for Disease Control and Prevention, this study assessed CHW integration across three North Carolina FQHCs with distinct patient populations, management systems, and levels of prior CHW experience to identify facilitators, barriers, and CHW impact.</p><p><strong>Methods: </strong>We conducted a qualitative evaluation using inductive thematic analysis of semistructured key informant interviews with CHWs, their managers, and clinicians at each FQHC. Transcripts were analyzed using reflexive thematic analysis to identify themes and extract representative quotes.</p><p><strong>Results: </strong>Facilitators included collaboration, targeted training, management systems, prior CHW and clinician experience, and organizational support. Barriers included unclear CHW role definition, CHW capacity and community resource constraints, and inconsistent communication about integration strategies. CHWs supported care coordination, health-related social needs referrals, and chronic disease management, improving patient engagement and outcomes.</p><p><strong>Conclusions: </strong>Findings confirmed known enablers and barriers to CHW integration, including role definition, capacity constraints, resource availability, and supportive leadership. We additionally identified novel factors impacting CHW integration, including the influence of prior experience of CHWs and clinical staff, CHW leadership in workflow development, the role of peer-learning collaboratives, and the importance of inclusive communication and data practices. Integration was most successful when CHWs shaped workflows, clinicians and managers had foundational CHW understanding, and collaborative learning spaces enabled peer exchange. These findings highlight the importance of CHW-centered program design and implementation, and may enhance existing frameworks for clinical integration of CHWs in FQHCs and similar settings.</p>","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":" ","pages":"E121-E136"},"PeriodicalIF":1.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13249304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148151938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From the Editors: From Operations to Social Needs: Advancing Ambulatory Care Practice.","authors":"Kimberley H Geissler, E Lee Rosenthal, Durrell J Fox","doi":"10.1097/JAC.0000000000000560","DOIUrl":"10.1097/JAC.0000000000000560","url":null,"abstract":"","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":" ","pages":"E119-E120"},"PeriodicalIF":1.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148151884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing Access in Academic Medical Centers Through Incentive-Based Evening and Weekend Clinics.","authors":"Debbie A Aizenberg, Satyan Lakshminrusimha, Susan Murin, Sarah Button, Bruce L Hall, David A Lubarsky","doi":"10.1097/JAC.0000000000000557","DOIUrl":"10.1097/JAC.0000000000000557","url":null,"abstract":"<p><strong>Background: </strong>Academic medical centers face mounting challenges in providing timely access to ambulatory care.</p><p><strong>Objective: </strong>University of California (UC), Davis Health's innovative \"Access Plus\" program was a pilot program designed to expand ambulatory care hours into evenings and weekends while addressing physician work-life preferences.</p><p><strong>Approach: </strong>Launched in January 2023, the program offered physicians the option to provide care during extended hours for enhanced compensation. The initiative specifically targeted new patient appointments and UC Davis Health employees and families, creating a strategic approach to enhance physician and employee support for the initiative, reducing median days to be seen while supporting workforce wellness.</p><p><strong>Outcomes: </strong>Over 18 months, 138 physicians participated, out of 800 physicians with an ambulatory practice (17.3%), and the program served 4,312 patients, including 3,236 new patients, achieving a median 21-day reduction in wait times for new patients. While the direct program was essentially cost-neutral (negative contribution margin of <1%), the initiative generated substantial downstream revenue, resulting in a total contribution margin of $13.3 million.</p><p><strong>Next steps: </strong>The UC Davis Health experience demonstrates that academic health systems can successfully expand traditional operating hours through well-designed programs that balance physician preferences with organizational goals to meet patient needs. This approach not only improves patient access but also maintains physician acceptance and has paved the way for other health system initiatives to enhance ambulatory care delivery, leveraging physician workforce engagement.</p>","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":" ","pages":"E167-E173"},"PeriodicalIF":1.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13249314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148151959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Rates of Cardiac Stress Test Completion through Scheduling Interventions.","authors":"Maelys J Amat, Dru A Ricci, Jasper Su, James C Benneyan, Anjala Tess, Ernest V Gervino, Naing Aung, Scot B Sternberg, Amie A Pollack, Leonor Fernandez, Talya Salant, Mark D Aronson, Gordon D Schiff, Russell S Phillips","doi":"10.1097/JAC.0000000000000558","DOIUrl":"10.1097/JAC.0000000000000558","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate the impact of a multi-layered intervention on improving rates of cardiac stress test scheduling and completion by reducing barriers to scheduling.</p><p><strong>Methods: </strong>Using a nonrandomized mixed-methods pre-post design, we identified patients for whom a stress test was ordered in primary care but had not been scheduled within 4 weeks. The first intervention consisted of proactive outreach phone calls by a primary care patient service representative for test scheduling. The second intervention consisted of priming phone calls to patients, which served as a reminder to schedule their appointment and an invitation to participate in a brief, semi-structured interview to understand barriers to test scheduling. Changes in scheduling rates and completion rates were analyzed using hypothesis tests, and time to completion was analyzed using X-bar/S charts.</p><p><strong>Results: </strong>Compared with the baseline cohort (n = 157), patients in the intervention cohort (n = 548) completed their stress tests at a significantly higher rate (66.2% [104] baseline; 81.0% [444] intervention; p = .00008). Patients in the intervention cohort similarly scheduled their tests at an improved rate (70.1% [110] baseline; 91.2% [500] intervention). Time to test completion was also significantly reduced in the intervention group (44.70 days [σ = 72.93] baseline; 33.6 days [σ = 26.67] intervention). Interviews revealed that patients had trouble scheduling their tests due to a lack of time and confusing processes.</p><p><strong>Conclusions: </strong>A multi-layered outreach intervention was successful in improving the rates of completion and scheduling for cardiac stress tests, as well as reducing time to completion. The pilot was found to be cost-effective, but may increase workload for primary care staff. Future studies should investigate ways to automate processes to reduce the burden on the system. Our study describes a potentially quality-improving intervention by introducing a new scheduling process, which is not the existing standard of care.</p>","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":"49 3","pages":"E161-E166"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148212827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}