Dangers of long waiting times for outpatient appointments at a urology clinic.

German, K.; Nuwahid, F; Matthews, P.; Stephenson, Terence

doi:10.1136/bmj.306.6875.429

Cited by 20 publications

(7 citation statements)

References 4 publications

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“…One study from England examined 55 patients who had been triaged as non-urgent and who would have otherwise waited for an average of 13 weeks to see a urologist and found that seven of the 55 patients ultimately went on to be diagnosed with a urological malignancy relating to their initial complaint. 6 Furthermore, a Canadian study found that longer wait times increased the overall mortality of patients diagnosed with bladder cancer. 7 To help reduce long wait times, innovative technologies must be incorporated into our practice to improve access to specialists.…”

Section: Introductionmentioning

confidence: 99%

Improving access to urologists through an electronic consultation service

Witherspoon

Liddy²,

Afkham³

et al. 2017

CUAJ

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Introduction: Access to specialist services is limited by wait times and geographic availability. Champlain Building Access to Specialist Advice (BASE) has been implemented in our service region to facilitate access to specialists by primary care providers (PCPs). Through a secure web-based system, PCPs are able to send eConsults instead of requesting a formal in-office consultation. Methods: Urology eConsults completed through the Champlain BASE service from March 2013 to January 2015 were analyzed. Each consult was characterized in regard to the type of question asked by the referring physician and the clinical content of the referral. Using the mandatory close-out surveys, we analyzed rates of referral avoidance, physician satisfaction, and overall impact on patient care. Results: Of 190 eConsultations, 70% were completed in less than 10 minutes. The most common clinical questions related to the interpretation of imaging reports (16%) and tests to choose for investigating a condition (15%). The most common diagnoses were hematuria (13%) and renal mass (8%). In 35% of cases, referral to a urologist had originally been contemplated and was avoided. In 8% of cases, a PCP did not believe a consultation was initially needed, but a referral was ultimately initiated after the eConsultation. Conclusions: Our study shows that although certain clinical presentations still require a formal in-person urological consultation, eConsultations can potentially reduce unnecessary clinic visits while identifying patients who may benefit from early urological consultation. Through both these mechanisms, we may improve timely access to urologists.

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Section: Introductionmentioning

confidence: 99%

Improving access to urologists through an electronic consultation service

Witherspoon

Liddy²,

Afkham³

et al. 2017

CUAJ

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show abstract

“…(10) Results of the (11) Great pressure has recently been put on clinicians by hospital managers and politicians to reduce appointment time. (12) Ensuring timely access to health care is a major policy concern as delayed access has been found to decrease patient satisfaction. (13) This goes hand in hand with results of the present study where 74.4%, of patients with delayed appointment were dissatisfied in comparison to 67% of patients without delayed appointment (Table 2).…”

Section: Discussionmentioning

confidence: 99%

Appointment Delay among Patients Attending Endocrinology Outpatient Clinic of Al-Qatif Central Hospital, Kingdom of Saudi Arabia

El-Mahalli

2009

Journal of High Institute of Public Health

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Patient's appointment is a fixed mutual agreement between patient and any health care giver to obtain the required medical services that suit his/ her health needs. Appointment delays in outpatient clinics are the most important cause for patients' dissatisfaction due to the complications that might develop during the wait time and consequently affecting their health status. The present study aimed to measure the appointment time from referral from primary health care centers to get the first appointment for patients cared for the most common diseases in the endocrinology outpatient clinic of Al-Qatif Central Hospital, and study reasons and effect of delayed appointment on patients. It is a cross-sectional descriptive study. The target population was medical records and database of 200 patients, all the working staff, and patients attended the study clinic during the year 2008. Results revealed that 60.5% of the patients had delayed appointment, while 39.5% had no delayed appointment. The acceptable appointment time delay for diabetes mellitus, hypothyroidism and hyperthyroidism were (X = 55± 8.66, 95 ± 5.00 and 19 ± 4.35 days respectively) in comparison to the current appointment time delay (X =118.3±81.0, 113.6±70.4 and 87.9±49.7 days respectively). Most of the patients with delayed appointment were dissatisfied (74.4%) compared to only 67% of those with no delayed appointment. Also, 22.3% of the patients with delayed appointment perceived that their health status was affected to a great extent in comparison to only 10.1% of those with no delayed appointment. Among the reasons mentioned by the working staff for delayed appointment were increased number of "no show" patients, population served by the study hospital, and follow up visits (83.3% each). Accordingly, the present study recommended availability of a center for diagnosis and treatment of diabetes mellitus in addition to the outpatient clinic of the study hospital; developing a system for reminding patients with the date of appointment e.g. SMS, telephone call,…etc; and establishing a prioritizing system for appointments based on emergency of the conditions.

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“…The time elapsing between a patient's initial presentation with symptoms to a general practitioner and attendance at an outpatient clinic may be crucial in conditions like cancer, in which early diagnosis may be vital 6. Extending the monitoring process to outpatient referrals would help to ensure that the referral pattern of general practitioner fundholders is not distorted by, for example, end of year financial considerations.…”

Section: Discussionmentioning

confidence: 99%

Waiting times: monitoring the total postreferral wait

Smith

1994

BMJ

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Objectives-To determine whether the period spent on the true inpatient waiting list is a valid indication ofthe total time that patients have to wait for an operation; and to assess the feasibility of monitoring the total "postreferral waiting time" by using existing computerised information systems.Setting-Three randomly selected Scottish hospitals.Subjects-Waiting list patients admitted to hospital for operations during June to August 1993 in six major specialties, separate attention being focused on cataract operations and hip and knee replacements.Main outcome measure-The total time that patients have to wait for an operation after the initial general practitioner referral-the postreferral waiting time-compared with that spent at the final stage ofthe process on the true inpatient waiting list.Results

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Dangers of long waiting times for outpatient appointments at a urology clinic.

Cited by 20 publications

References 4 publications

Improving access to urologists through an electronic consultation service

Improving access to urologists through an electronic consultation service

Appointment Delay among Patients Attending Endocrinology Outpatient Clinic of Al-Qatif Central Hospital, Kingdom of Saudi Arabia

Waiting times: monitoring the total postreferral wait

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