Cargando…

Improving accessibility for outpatients in specialist clinics: reducing long waiting times and waiting lists with a simple analytic approach

BACKGROUND: Lack of resources is often cited as a reason for long waiting times and queues in health services. However, recent research indicates these problems are related to factors such as uncoordinated variation of demand and capacity, planning horizons, and lower capacity than the potential of...

Descripción completa

Detalles Bibliográficos
Autores principales: Johannessen, Karl Arne, Alexandersen, Nina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6211460/
https://www.ncbi.nlm.nih.gov/pubmed/30382845
http://dx.doi.org/10.1186/s12913-018-3635-3
_version_ 1783367337747939328
author Johannessen, Karl Arne
Alexandersen, Nina
author_facet Johannessen, Karl Arne
Alexandersen, Nina
author_sort Johannessen, Karl Arne
collection PubMed
description BACKGROUND: Lack of resources is often cited as a reason for long waiting times and queues in health services. However, recent research indicates these problems are related to factors such as uncoordinated variation of demand and capacity, planning horizons, and lower capacity than the potential of actual resources. This study aimed to demonstrate that long waiting times and wait lists are not necessarily associated with increasing demand or changes in resources. We report how substantial reductions in waiting times/wait lists across a range of specialties was obtained by improvements of basic problems identified through value-stream mapping and unsophisticated analyses. METHODS: In-depth analyses of current operational processes by value-stream mapping were used to identify bottlenecks and sources of waste. Waiting parameters and measures of demand and resources were assessed monthly from 12 months before the intervention to 6 months after the intervention. The effect of the intervention on reducing waiting time and number of patients waiting were evaluated by a difference-in-differences analysis. RESULTS: Mean waiting time across all clinics was reduced from 162 + 69 days (range 74–312 days) at baseline to 52 + 10 days (range 41–74 days) 6 months after the intervention. The time needed to achieve a waiting time of 65 days varied from 4 to 21 months. The number of new patients waiting was reduced from 15,874 (range 369–2980) to 8922 (range 296–1650), and the number of delayed returning patients was reduced from 18,700 (310–3324) to 5993 (40–1337) (p < 0.01 for all). Improvement in waiting measures paralleled a significant increase in planning horizon. CONCLUSIONS: Significant improvements in accessibility for patients waiting for service may be achieved by applying unsophisticated methods and analyses and without increasing resources. Engagement of clinical management and involvement of front line personnel are important factors for improvement.
format Online
Article
Text
id pubmed-6211460
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-62114602018-11-08 Improving accessibility for outpatients in specialist clinics: reducing long waiting times and waiting lists with a simple analytic approach Johannessen, Karl Arne Alexandersen, Nina BMC Health Serv Res Research Article BACKGROUND: Lack of resources is often cited as a reason for long waiting times and queues in health services. However, recent research indicates these problems are related to factors such as uncoordinated variation of demand and capacity, planning horizons, and lower capacity than the potential of actual resources. This study aimed to demonstrate that long waiting times and wait lists are not necessarily associated with increasing demand or changes in resources. We report how substantial reductions in waiting times/wait lists across a range of specialties was obtained by improvements of basic problems identified through value-stream mapping and unsophisticated analyses. METHODS: In-depth analyses of current operational processes by value-stream mapping were used to identify bottlenecks and sources of waste. Waiting parameters and measures of demand and resources were assessed monthly from 12 months before the intervention to 6 months after the intervention. The effect of the intervention on reducing waiting time and number of patients waiting were evaluated by a difference-in-differences analysis. RESULTS: Mean waiting time across all clinics was reduced from 162 + 69 days (range 74–312 days) at baseline to 52 + 10 days (range 41–74 days) 6 months after the intervention. The time needed to achieve a waiting time of 65 days varied from 4 to 21 months. The number of new patients waiting was reduced from 15,874 (range 369–2980) to 8922 (range 296–1650), and the number of delayed returning patients was reduced from 18,700 (310–3324) to 5993 (40–1337) (p < 0.01 for all). Improvement in waiting measures paralleled a significant increase in planning horizon. CONCLUSIONS: Significant improvements in accessibility for patients waiting for service may be achieved by applying unsophisticated methods and analyses and without increasing resources. Engagement of clinical management and involvement of front line personnel are important factors for improvement. BioMed Central 2018-11-01 /pmc/articles/PMC6211460/ /pubmed/30382845 http://dx.doi.org/10.1186/s12913-018-3635-3 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Johannessen, Karl Arne
Alexandersen, Nina
Improving accessibility for outpatients in specialist clinics: reducing long waiting times and waiting lists with a simple analytic approach
title Improving accessibility for outpatients in specialist clinics: reducing long waiting times and waiting lists with a simple analytic approach
title_full Improving accessibility for outpatients in specialist clinics: reducing long waiting times and waiting lists with a simple analytic approach
title_fullStr Improving accessibility for outpatients in specialist clinics: reducing long waiting times and waiting lists with a simple analytic approach
title_full_unstemmed Improving accessibility for outpatients in specialist clinics: reducing long waiting times and waiting lists with a simple analytic approach
title_short Improving accessibility for outpatients in specialist clinics: reducing long waiting times and waiting lists with a simple analytic approach
title_sort improving accessibility for outpatients in specialist clinics: reducing long waiting times and waiting lists with a simple analytic approach
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6211460/
https://www.ncbi.nlm.nih.gov/pubmed/30382845
http://dx.doi.org/10.1186/s12913-018-3635-3
work_keys_str_mv AT johannessenkarlarne improvingaccessibilityforoutpatientsinspecialistclinicsreducinglongwaitingtimesandwaitinglistswithasimpleanalyticapproach
AT alexandersennina improvingaccessibilityforoutpatientsinspecialistclinicsreducinglongwaitingtimesandwaitinglistswithasimpleanalyticapproach