"The Seven As of Access" with Kevin Ahmaad Jenkins, PhD

Tools for Equity: The 7 As of Access

Limitations on access are at the core of health disparities. If patients cannot access timely and appropriate medical care, their health outcomes suffer. Building on Roy Penchansky and William Thomas’s seminal article, “The Concept of Access,” Master of Health Care Innovation faculty member Kevin Ahmaad Jenkins offers a 7-point framework for assessing and expanding access in health care organizations: 

  • Awareness 
    Inform patients about your services. Are you communicating effectively to the public? Are you raising awareness that your services are available to underserved populations? 

  • Affordability 
    Address barriers to cost. Is your care affordable to underserved populations? Do you have a sliding scale? Are patients aware of it? 

  • Acceptability 
    Understand what constitutes acceptable service from the patient standpoint. Are you asking patients what works for them, and what they need to build a relationship with your organization? 

  • Accessibility 
    Consider physical barriers to access. Do patients have to travel too far to access care? Is transportation inconvenient, unaffordable, or nonexistent? 

  • Availability 
    Create capacity to meet patient needs. Does your organization have enough personnel, and offer appropriate services, to suit the populations served? And, if not, can you refer patients to accessible specialists? 

  • Accommodation 
    Assess the flexibility of your services. Do you have email and telehealth access? Can you offer services when patients are available, in the evening or on weekends? 

  • Accountability 
    Building mechanisms to hold your organization responsible. Do you set targets and track metrics for access and equity? Is staff accountable for its attitudes and actions? Do you communicate that accountability to all constituents—including patients? 

Understanding the various dimensions of access creates a nuanced view that allows organizations to pinpoint areas in need of improvement and take steps to address those gaps. 

Bring this framework into your own work by downloading this 7 As of Access job aid.