Improving accessibility through referral management: setting targets for specialist care

Greenwood-Lee, James; Wild, Geoff; Marshall, Deborah

doi:10.1057/hs.2015.20

Cited by 7 publications

(3 citation statements)

References 17 publications

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“…One way to improve patient flows is to increase the availability of resources, but this is not always feasible when resources are constrained. A single-entry model (SEM) or central intake system is a commonly-used wait time management strategy to increase access and flow through the system of care [ [15] , [16] , [17] , [18] , [19] ]. Nonetheless, SEMs are not currently commonplace in Canada, nor are they standard policy or practice [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

Wait time management strategies at centralized intake system for hip and knee replacement surgery: A need for a blended evidence-based and patient-centered approach

Marshall¹,

Bischak²,

Zaerpour³

et al. 2022

Osteoarthritis and Cartilage Open

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Section: Introductionmentioning

confidence: 99%

Wait time management strategies at centralized intake system for hip and knee replacement surgery: A need for a blended evidence-based and patient-centered approach

Marshall¹,

Bischak²,

Zaerpour³

et al. 2022

Osteoarthritis and Cartilage Open

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“…A set of candidate strategies for optimization of CI was identified during a 1‐day stakeholder meeting. Participants (patients and PaCERs [n = 2], health‐care professionals [n = 10], health‐care administrators [n = 7] and academic researchers [n = 9]) were presented with the elements of predefined based on the literature and discussions with relevant stakeholders candidate strategies for CI. Afterwards, participants reflected on proposed models and provided feedback to develop the preferred model for Alberta.…”

Section: Resultsmentioning

confidence: 99%

The voice of patients in system redesign: A case study of redesigning a centralized system for intake of referrals from primary care to rheumatologists for patients with suspected rheumatoid arthritis

Lopatina

Miller

Teare

et al. 2018

Health Expectations

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Background The published literature demands examples of health‐care systems designed with the active engagement of patients to explore the application of this complex phenomenon in practice. Methods This case study explored how the voice of patients was incorporated into the process of redesigning an element of the health‐care system, a centralized system for intake of referrals from primary care to rheumatologists for patients with suspected rheumatoid arthritis (RA)—centralized intake. The phenomenon of patient engagement using “patient and community engagement researchers” (PaCERs) in research and the process of redesigning centralized intake were selected as the case. In‐depth evaluation of the case was undertaken through the triangulation of findings from the document review and participants’ reflection on the case. Results In this case, patients and PaCERs participated in multiple activities including an initial meeting of key stakeholders to develop the project vision; a patient‐to‐patient PaCERs study to gather perspectives of patients with RA on the challenges they face in accessing and navigating the health‐care system, and what they see as key elements of an effective system that would be responsive to their needs; the development of an evaluation framework for future centralized intake; and the choice of candidate centralized intake strategies to be evaluated. Conclusions The described feasible multistep approach to active patient engagement in health‐care system redesign contributes to an understanding of the application of this complex phenomenon in practice. Therefore, the manuscript serves as one more step towards a patient‐centred health‐care system that is redesigned with active patient engagement.

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“…In addition, better streamlining is required so that only those individuals requiring specialist opinion are referred. Taken together, this may help avoid delays in care, interruptions of patient flow and suboptimal use of resources 25 46…”

Section: Discussionmentioning

confidence: 99%

Musculoskeletal care pathways for adults with hip and knee pain referred for specialist opinion: a systematic review

et al. 2019

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ObjectiveMusculoskeletal care pathways are variable and inconsistent. The aim of this systematic review was to evaluate the evidence for the clinical and/or cost effectiveness of current care pathways for adults with hip and/or knee pain referred for specialist opinion.DesignSystematic review.Data sourcesElectronic database searches were carried out in MEDLINE, MEDLINE In-Process, Cumulative Index of Nursing and Allied Health Literature, Embase, PEDro, PubMed, Web of Science, Cochrane Central and Health Management Information Consortium without language restriction from 1990 onwards. Websites were reviewed for grey literature.Eligibility criteriaAll study designs and documents that considered care pathways for adults with musculoskeletal hip and/or knee pain referred for specialist opinion were screened by two reviewers. Risk of bias was assessed using The Critical Appraisal Skills Programme checklist for randomised controlled trials and the Joanna Briggs Institute checklists.Data extraction and synthesisData extraction and quality assessment were performed by one reviewer and checked by a second. Findings are reported narratively.ResultsThe titles and abstracts of 1248 articles were screened and 140 full-text articles retrieved. 19 papers reporting 17 studies met the study inclusion criteria. Quality was low due to study design and methodological flaws. Most of the outcomes relate to organisational process at the ‘meso’ level of a whole systems approach.ConclusionIt can be concluded that the pathway is not linear, containing variations and activity loops. The available evidence suggests that, from the point of referral for specialist opinion, a model is required that integrates the skills of all the different healthcare professionals and streamlining is required to ensure that individuals are seen by the healthcare professional that best meets their needs. There is very limited evidence of patient experience informing knee and hip care pathways.PROSPERO registration numberCRD42016035510.

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Improving accessibility through referral management: setting targets for specialist care

Cited by 7 publications

References 17 publications

Wait time management strategies at centralized intake system for hip and knee replacement surgery: A need for a blended evidence-based and patient-centered approach

Wait time management strategies at centralized intake system for hip and knee replacement surgery: A need for a blended evidence-based and patient-centered approach

The voice of patients in system redesign: A case study of redesigning a centralized system for intake of referrals from primary care to rheumatologists for patients with suspected rheumatoid arthritis

Musculoskeletal care pathways for adults with hip and knee pain referred for specialist opinion: a systematic review

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