Background
Waiting lists should be managed as fairly as possible to ensure that patients with greater or more urgent needs receive services first. Patient prioritization refers to the process of ranking referrals in a certain order based on various criteria with the aim of improving fairness and equity in the delivery of care. Despite the widespread use of patient prioritization tools (PPTs) in healthcare services, the existing literature on this subject has mainly focused on emergency settings. Evidence has not been synthesized with respect to all the non-emergency services.
Methods
This review aims to perform a systematic synthesis of published evidence concerning (1) prioritization tools’ characteristics, (2) their metrological properties, and (3) their effect measures across non-emergency services. Five electronic databases will be searched (Cochrane Library, Ovid/MEDLINE, Embase, Web of Science, and CINAHL). Eligibility criteria guiding data selection will be (1) qualitative, quantitative, or mixed methods empirical studies; (2) patient prioritization in any non-emergency setting; and (3) discussing characteristic, metrological properties, or effect measures. Data will be sought to report tool’s format, description, population, setting, purpose, criteria, developer, metrological properties, and outcome measures. Two reviewers will independently screen, select, and extract data. Data will be synthesized with sequential exploratory design method. We will use the Mixed Methods Appraisal Tool (MMAT) to assess the quality of articles included in the review.
Discussion
This systematic review will provide much-needed knowledge regarding patient prioritization tools. The results will benefit clinicians, decision-makers, and researchers by giving them a better understanding of the methods used to prioritize patients in clinical settings.
Systematic review registration
PROSPERO
CRD42018107205
Electronic supplementary material
The online version of this article (10.1186/s13643-019-0992-x) contains supplementary material, which is available to authorized users.
Emergency medical services (EMS) are dedicated to provide urgent medical care to any person requiring it and to ensure their transport to a hospital or care facility, if required. Moreover, in many contexts, EMS also have to provide transportation services for patients need to go from one hospital to another or between their home and the hospital. For such organisations, efficient strategies for managing the ambulance fleet at their disposal have to be selected, but the highly random and dynamic nature of the system under study makes this a challenging task. Most of the published studies which have considered these issues have done it focusing on a specific EMS context, one city or one territory for instance. However, it is possible to identify several common characteristics and processes from one EMS context to another. This is the purpose of the generic discrete event simulation-based analysis tool proposed here, which can be adapted to a wide range of EMS contexts. In particular, it explicitly considers the two types of tasks that can compose the mission of an EMS: serving emergency requests and providing transports between care units/hospitals/patients' homes.
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