Waiting it out: consultation delays prolong in-patient length of stay

Rahman, Arifeen S.; Shi, Siyu; Meza, Pamela K.; Jia, Justin L.; Svec, David; Shieh, Lisa

doi:10.1136/postgradmedj-2018-136269

Cited by 17 publications

(18 citation statements)

References 28 publications

(10 reference statements)

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“…Residents may withdraw the request for a consultation with fellows due to the difficulty. Therefore, because delays in consultation can have a negative impact on patient care [ 9 ], consultants should be aware that they need to demonstrate a willingness to accept consultation requests.…”

Section: Discussionmentioning

confidence: 99%

“…It includes providing professional recommendations, writing notes, following up on patients daily, and teaching residents [ 1 , 2 ]. In recent years, the number of consultations has increased [ 4 ], and there have been numerous reports of the positive association between consultations and favourable patient outcomes, including associations with reduced mortality [ 5 – 7 ], readmission [ 6 , 8 ], and length of stay [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

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Essential consultants’ skills and attitudes (Willing CONSULT): a cross-sectional survey

et al. 2021

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Background Despite multi-professional collaboration via consultation being increasingly important given the variety of disease diagnoses and treatment, the key elements as consultants remain unclear. The study aimed to identify the skills and attitudes that are important for consultants from the residents’ perspective so that they can be targeted as priority goals in subsequent educational interventions. Methods We conducted our research in two phases: a preliminary survey (May 1 to 14, 2020) and a main survey (June 1 to 14, 2020). As a preliminary survey, first-year postgraduate residents at St. Luke’s International Hospital in Tokyo, Japan, were first asked an open-ended question about the types of skills and attitudes that are important for consultants. After eliminating duplicate answers, there were 19 skills and attitudes in total. In the main survey with residents who completed their residency training at our institute, from 2014 to 2018 and current residents (2019–2020), we first asked them about their demographic characteristics (gender, years of postgraduate education, and type of specialty). Then, they answered how important each skill and attitude are for consultants. All 19 items were scored on a seven-point Likert scale that ranged from 0 (completely disagree) to 6 (totally agree). Cronbach’s alpha confirmed the internal consistency of the questionnaire items. Principal component analysis and exploratory factor analysis were performed. Results The survey included 107 individuals (61.1 %, 175 potential participants). The median postgraduate years of education was four (interquartile range: 2–5), and 64.5 % were men (n = 69). Seven key elements for consultants were identified and termed Willing CONSULT. These included (1) willingness (willingness to accept consultation requests), (2) contact (easy access to consultants), (3) needs (consideration of consulters’ needs), (4) suggestions and support (providing clear recommendations and suggestions, following up on the patients, and supporting the consulters continuously), (5) urgency (considering the situation’s urgency and responding appropriately), (6) learning opportunities (providing teaching points), and (7) text (writing medical records). Conclusions We propose Willing CONSULT, which are important skills and attitudes for consultants.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Essential consultants’ skills and attitudes (Willing CONSULT): a cross-sectional survey

et al. 2021

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“…6,7 In high complexity environments, long waiting lists and delays in service delivery unnecessarily increase length of hospitalization time. 8 Difficulty in getting appointments is one of the main causes of dissatisfaction, given that having to wait for long periods of time generally results in shorter consultations. 8 Whereas waiting time is attributed to organizational processes, length of consultation is characterized by health demands and concerns, that differ between individuals and, for this reason, require empathetic interactions.…”

Section: Introductionmentioning

confidence: 99%

“…8 Difficulty in getting appointments is one of the main causes of dissatisfaction, given that having to wait for long periods of time generally results in shorter consultations. 8 Whereas waiting time is attributed to organizational processes, length of consultation is characterized by health demands and concerns, that differ between individuals and, for this reason, require empathetic interactions. 9 Greater length of medical consultation time does not necessarily improve Primary Health Care performance results, including prescriptions issued, requests for laboratory tests and referrals, or patient satisfaction with the service provided.…”

Section: Introductionmentioning

confidence: 99%

Tempo de espera e duração da consulta médica na região metropolitana de Manaus, Brasil: estudo transversal de base populacional, 2015*

Galvão¹,

Tiguman²,

Filho³

et al. 2020

Epidemiologia e Serviços de Saúde

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Objective. To assess waiting times and length of medical consultations in the Manaus metropolitan region, Brazil. Methods. This was a cross-sectional study conducted with adults living in the region in 2015. Waiting time for consultation and length of consultation in minutes were reported by the participants. Analysis was performed using Tobit regression and weighted by the sample design. Results. 4,001 individuals were interviewed. Average waiting time was 125.4 minutes (95%CI 120.2;130.5), while consultations lasted an average of 52.5 minutes (95%CI 48.0;57.0). Women, poor people, people with less education, indigenous people, people resident in the state interior, people without health insurance, and individuals seen by gynecologists waited longer for their consultation (p <0.05). Consultation time was shorter for non-White people, those with poor health status and those who had health insurance (p <0.05). Conclusion. On average length of medical consultations was half the waiting time. Social inequalities were observed in these lengths of time.

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“…We would like to commend Rahman et al for their work highlighting the reasons for delays in inpatient consultations 1. The authors found that miscommunication between referring and receiving teams was responsible for 34% of all delays each with an average delay of 1.6 days in length of stay (combining communication and power dynamic categories).…”

mentioning

confidence: 99%