The Successful, Sustainable Elimination of a Waiting List for Urology Outpatients

Willis, Susan; Pardos-Martinez, Maria; Coker, Bola; Thomas, Kay; Anderson, Paul D.; Rottenberg, Giles; Jenkins, Elaine; O’Brien, Tim

doi:10.1111/j.1464-410x.2010.09952.x

Cited by 12 publications

(18 citation statements)

References 13 publications

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“…The efficiency markers we measured were improved by the one-stop clinic. As others have reported, this was achieve by matching capacity to demand and equipping the clinic with the most commonly requested investigations 5. A one-stop clinic has several advantages over other efficiency strategies.…”

Section: Discussionmentioning

confidence: 99%

“…In contrast to other reports, the clinic was set up with minimal capital costs,5 by re-organising existing resources, rather than investing in new facilities. We did not require a clinic coordinator employed by others,5 relying on a menu of tests similar to the Mayo clinic itinerary. We have reproduced the service in our satellite hospital and therefore believe it can be reproduced in any sizeable urology unit with minimal expenditure.…”

Section: Discussionmentioning

confidence: 99%

“…The clinic was modelled on a previously reported one-stop urology clinic 5. Key investigations including diagnostic ultrasound, flexible cystoscopy, plain X-ray, transrectal ultrasound (TRUS) guided prostate biopsy, uroflometry, and blood tests were available in clinic.…”

Section: Methodsmentioning

confidence: 99%

“…However, such strategies can introduce inequality and/or are difficult to sustain. An alternative pathway is a one-stop clinic in which all new referrals are seen in a single clinic and, if possible, investigated at their initial visit 5…”

Section: Introductionmentioning

confidence: 99%

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The new standard of care in urology outpatients? A one-stop clinic improves efficiency and quality

Barrass

Wood

2013

Journal of Clinical Urology

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Objective The objective of this article is to determine retrospectively if a one-stop clinic for all new urology referrals improved the efficiency and quality of our outpatient pathway. We considered any improvement in productivity (e.g. waiting times) to indicate improved efficiency as resources were not increased. We considered any improvement in the level and continuity of specialist care to indicate improved quality as these factors have both been associated with measures of quality such as patient satisfaction. Patients and methods Quality and efficiency markers were recorded and compared for 100 consecutive urology referrals from 1 October before (2010) and after (2011) introduction of the clinic. Efficiency markers recorded were waiting times, discharge rate, number of dictated letters and clinic attendance. Quality markers recorded were grade and continuity of specialist care. Results The new appointment wait dropped from seven to two weeks. The commonest tests (flexible cystoscopy and ultrasound) were virtually all completed at first attendance. Median hospital visits before diagnosis dropped from two to one (p < 0.001). The discharge rate rose from 5/100 to 19/100 (p < 0.001). More patients (72/100 versus 42/100) were seen by a consultant and more cystoscopies (23/25 (92%) versus 1/28 (3.3%)) were performed by the urologist requesting them (p < 0.0001). The median number of dictated letters per diagnosis dropped from three to two in the one-stop clinic (p = 0.002). Conclusion The one-stop clinic significantly improved efficiency and quality markers for all new referrals, thereby improving access and reducing inequality. The clinic was inexpensive to introduce, and wider adoption of similar clinics could improve access to urological care.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The new standard of care in urology outpatients? A one-stop clinic improves efficiency and quality

Barrass

Wood

2013

Journal of Clinical Urology

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“…Delayed access to specialist medical outpatient clinics is a serious problem [20]. This project aims to determine whether an evidence-based model of access, STAT, that reduced waiting time in community outpatient services [6] can be successfully applied to a specialist medical outpatient clinic serving patients with epilepsy to achieve reduced wait time.…”

Section: Introductionmentioning

confidence: 99%

Specific timely appointments for triage to reduce wait times in a medical outpatient clinic: protocol of a pre-post study with process evaluation

Lewis

Taylor

Carney

et al. 2019

BMC Health Serv Res

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BackgroundManaging demand for services is a problem in many areas of healthcare, including specialist medical outpatient clinics. Some of these clinics have long waiting lists with variation in access for referred people. A model of triage and appointment allocation has been developed and tested that has reduced waiting times by about a third in community outpatient services. This study aims to determine whether the model can be applied in the setting of a specialist medical outpatient clinic to reduce wait time from referral to first appointment.MethodsA pre-post study will collect data before and after implementing the Specific Timely Appointments for Triage (STAT) model of access and triage. The study will incorporate a pre-implementation period of 12 months, an implementation period of up to 6 months and a post STAT-implementation period of 6 months. The setting will be the epilepsy clinic at a metropolitan health service in Melbourne. Included will be all people referred to the clinic, or currently waiting, during the allocated periods of data collection (total sample estimated n = 975). Data routinely collected by the health service and qualitative data from staff will be analysed to determine the effects of introducing the STAT model. The primary outcome will be wait time, measured by number of patients on the wait list at monthly time points and the mean number of days waited from referral to first appointment. Secondary outcomes will include patient outcomes, such as admission to hospital while waiting, and service outcomes, including rate of discharge. Analysis of the primary outcome will include interrupted time series analysis and simple comparisons of the pre and post-implementation periods. Process evaluation will include investigation of the fidelity of the intervention, adaptations required and qualitative analysis of the experiences of clinic staff.DiscussionPrompt access to service and optimum patient flow is important for patients and service providers. Testing the STAT model in a specialist medical outpatient clinic will add to the evidence informing service providers and policy makers about how the active management of supply and demand in health care can influence wait times. The results from this study may be applicable to other specialist medical outpatient clinics, potentially improving access to care for many people.

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Does clinical validation and the implementation of new models of outpatient service delivery have the potential to reduce waiting lists? A pilot study in Letterkenny University Hospital

et al. 2020

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The Successful, Sustainable Elimination of a Waiting List for Urology Outpatients

Cited by 12 publications

References 13 publications

The new standard of care in urology outpatients? A one-stop clinic improves efficiency and quality

The new standard of care in urology outpatients? A one-stop clinic improves efficiency and quality

Specific timely appointments for triage to reduce wait times in a medical outpatient clinic: protocol of a pre-post study with process evaluation

Does clinical validation and the implementation of new models of outpatient service delivery have the potential to reduce waiting lists? A pilot study in Letterkenny University Hospital

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