scholarly journals EP.WE.727Upper GI Surgery Clinic Referrals; Can We Improve the Patient Experience?

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Mohamed Abouelazayem ◽  
Raluca Belchita
Keyword(s):  
Patient Experience ◽  
Waiting Time ◽  
Waiting Times ◽  
Patient Records ◽  
Electronic Patient Records ◽  
Post Discharge ◽  
Average Waiting Time ◽  
Upper Gi

Abstract Aim To review the new referrals to the Upper GI surgery clinic for appropriateness, investigations requested, and waiting times and to identify potential pathways to reduce waiting times and improve the patient experience. Method Patients who attended the UGI clinic over 2 months period were identified. Data were collected from GP referrals and Electronic Patient Records. Follow up, post-discharge appointments, and Did Not Attends were excluded. Data collected included time from referral to first clinic, symptoms, investigations requested, suitability for a pathway, and appropriateness of referral. A first clinic outcome was concluded from reading the GP referral, there were 5 outcomes to choose from; direct to another specialty, discharge back to GP, clinic, surgery, pre-investigate and clinic. Results 147 referrals were analysed. The average waiting time from referral to the first clinic was 51 days (range 7-119 days). 73% of the referrals were GP referrals and 27% from other specialties. The most common referral was for gallstones and the most common 2 outcomes were Pre-investigate and surgery. Conclusion Most of the investigations and outcomes suggested from the project were the same as those from clinic letters. The following pathways can be developed to cut waiting times and costs for the trust:

scholarly journals 499 Upper GI Surgical Clinic Referrals, Can We Improve Patient Experience?

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
M Abouelazayem ◽  
R Belchita ◽  
A Wan
Keyword(s):  
Patient Experience ◽  
Waiting Times ◽  
Outpatient Clinics ◽  
Biliary Colic ◽  
Post Discharge ◽  
Upper Gi ◽  
Clinic Appointment ◽  
Improve Patient ◽  
Surgical Clinic

Abstract Introduction With increasing pressure on NHS to deal with long waiting lists, solutions to reduce waiting times are imperative. In the era of the COVID-19 pandemic, we need to reshape the way we look into Outpatient clinic appointments. Aim To review all clinic referrals to UGI surgical clinic and highlight any potential pathways that can improve waiting times and patient experience. Method Patients referred to UGI clinic over 2 months were collected from Iclip, EPR and EDM. Post-discharge appointments and DNA’s were excluded. Data collected included time from referral to clinic, type of referral, symptoms, investigations, potential pathway, first clinic outcome, and appropriateness of referral. Results Total of 147 referrals analyzed. Time from referral to clinic appointment is 51 days. GP referrals represented 73% while the rest from consultant colleagues. The most common symptoms were biliary colic and GORD. OGD and PH manometry were the most common investigations requested. The most common first outcome was pre investigate and clinic follow up. Two potential pathways identified are Biliary colic and GORD pathway. 90% of referrals were appropriate. Conclusions Biliary colic pathway and GORD pathway are 2 potential pathways that can cut off waiting times for clinic appointments and improve patient experience in outpatient clinics.

scholarly journals Reasons patients leave their nearest healthcare service to attend Karen Park Clinic, Pretoria North

2013 ◽  
Vol 5 (1) ◽  
Author(s):  
Agnes T. Masango- Makgobela ◽  
Indiran Govender ◽  
John V. Ndimande
Keyword(s):  
Healthcare Provider ◽  
Waiting Time ◽  
Healthcare Service ◽  
Waiting Times ◽  
Healthcare Providers ◽  
Descriptive Study ◽  
Staff Attitudes ◽  
Quality Service ◽  
Cross Sectional

Background: Many patients move from one healthcare provider or facility to another, disturbing the continuity that enhances holistic patient care.Objectives: To investigate the reasons given by patients for attending Karen Park Clinic rather than the clinic nearest to their homes.Methods: A cross-sectional descriptive study was conducted during 2010. Three hundred and fifty patients attending Karen Park Clinic were given questionnaires to complete, with the following variables: place of residence; previous attendance at the clinic nearest their home; services available at their nearest clinic; and their willingness to attend their nearest clinic in future.Results: Respondents were from Soshanguve (153; 43.7%), Mabopane (92; 26.3%), Garankuwa (29; 8.3%) and Hebron (20; 5.7%) and most were women (271; 77.4%) aged 26–45 (177; 50.6%). Eighty per cent (281) of the patients had visited their nearest clinic previously and 54 of these (19.2%) said they would not return. The reasons for this were: long waiting time (88; 25.1%); long queues (84; 24%); rude staff (60; 17%); and no medication (39; 11.1%).Conclusion: The majority of patients who had attended their nearest clinic were adamant that they would not return. It is necessary to reduce waiting times, thus reducing long queues. This can be achieved by having adequate, satisfied healthcare providers to render a quality service and by organising training for management. Patients can thus be redirected to their nearest clinic and the health centre’s capacity can be increased by procuring adequate drugs. There is a need to follow up on patients’ complaints about staff attitudes.

scholarly journals Measuring and Analyzing Waiting Time Indicators of Patients’ Admitted in Emergency Department: A Case Study

2015 ◽  
Vol 8 (1) ◽  
pp. 143 ◽  
Author(s):  
Saeed Amina ◽  
Ahmad Barrati ◽  
Jamil Sadeghifar ◽  
Marzeyh Sharifi ◽  
Zahra Toulideh ◽  
...  
Keyword(s):  
Emergency Department ◽  
Waiting Time ◽  
Waiting Times ◽  
Hospital Data ◽  
Governance System ◽  
Cross Sectional ◽  
Average Waiting Time ◽  
Study Population

<p><strong>BACKGROUND</strong><strong> </strong><strong>&amp;</strong><strong> </strong><strong>AIMS:</strong> Measuring and analyzing of provided services times in Emergency Department is the way to improves quality of hospital services. The present study was conducted with aim measuring and analyzing patients waiting time indicators in Emergency Department in a general hospital in Iran.</p> <p><strong>MATERIAL</strong><strong> </strong><strong>&amp;</strong><strong> </strong><strong>METHODS:</strong> This cross-sectional, observational study was conducted during April to September 2012. The study population consisted of 72 patients admitted to the Emergency Department at Baharlo hospital. Data collection was carried out by workflow forms. Data were analyzed by t.<strong> </strong>test and ANOVA.</p> <p><strong>RESULTS:</strong> The average waiting time for patients from admission to enter the triage 5 minutes, the average time from triage to physician visit 6 minute and the average time between examinations to leave ED was estimated 180 minutes. The total waiting time in the emergency department was estimated at about 210 minutes. The significant<strong> </strong>correlation between marital status of patients (P=0.03), way of arrive to ED (P=0.02) and type of shift work (P=0.01) with studied time indicators were observed.</p> <p><strong>CONCLUSION:</strong> According to results and comparing with similar studies, the average waiting time of patients admitted to the studied hospital is appropriate. Factors such as: Utilizing clinical governance system and attendance of resident Emergency Medicine Specialist have performed an important role in reducing of waiting times in ED.</p>

scholarly journals Impact of streaming "fast track" emergency department patients

2006 ◽  
Vol 30 (4) ◽  
pp. 525 ◽  
Author(s):  
Debra O'Brien ◽  
Aled Williams ◽  
Kerrianne Blondell ◽  
George A Jelinek
Keyword(s):  
Emergency Department ◽  
Length Of Stay ◽  
Waiting Time ◽  
Fast Track ◽  
Average Length ◽  
Waiting Times ◽  
Relative Reduction ◽  
Average Waiting Time ◽  
Discharged Patients ◽  
Track Area

Objective: Fast track systems to stream emergency department (ED) patients with low acuity conditions have been introduced widely, resulting in reduced waiting times and lengths of stay for these patients. We aimed to prospectively assess the impact on patient flows of a fast track system implemented in the emergency department of an Australian tertiary adult teaching hospital which deals with relatively few low acuity patients. Methods: During the 12-week trial period, patients in Australasian Triage Scale (ATS) categories 3, 4 and 5 who were likely to be discharged were identified at triage and assessed and treated in a separate fast track area by ED medical and nursing staff rostered to work exclusively in the area. Results: The fast track area managed 21.6% of all patients presenting during its hours of operation. There was a 20.3% (?18 min; 95%CI, ?26 min to ?10 min) relative reduction in the average waiting time and an 18.0% (?41 min; 95%CI, ?52 min to ?30 min) relative reduction in the average length of stay for all discharged patients compared with the same period the previous year. Compared with the 12-week period before the fast track trial, there was a 3.4% (?2.1 min; 95%CI, ?8 min to 4 min) relative reduction in the average waiting time and a 9.7% (?20 min; 95%CI, ?31 min to ?9 min) relative reduction in the average length of stay for all discharged patients. There was no increase in the average waiting time for admitted patients. This was despite major increases in throughput and access block in the study period. Conclusion: Streaming fast track patients in the emergency department of an Australian tertiary adult teaching hospital can reduce waiting times and length of stay for discharged patients without increasing waiting times for admitted patients, even in an ED with few low acuity patients.

scholarly journals How is patient activation related to healthcare service utilisation? Evidence from electronic patient records in England

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Feifei Bu ◽  
Daisy Fancourt
Keyword(s):  
Health Care ◽  
Healthcare Service ◽  
Patient Activation ◽  
Outcome Variable ◽  
Service Utilisation ◽  
Patient Records ◽  
Electronic Patient Records ◽  
Emergency Admissions ◽  
Gp Visits

Abstract Background There is increasing awareness of the importance of patient activation (knowledge, skills, and confidence for managing one’s health and health care) among clinicians and policy makers, with emerging evidence showing higher levels of patient activation are associated with better health outcomes and experiences of health care. This study aimed to examine the association between patient activation and a wide range of specific types of healthcare service utilisation in England, including GP and non-GP primary care, elective and emergency hospital admissions, outpatient visits, and attendances at the Accident and Emergency department. Methods Data were derived from linked electronic patient records collected by primary and secondary healthcare providers in North West London between January 2016 and November 2019. Our analyses focused on adults (18+) with a valid Patient Activation Measure (PAM). After excluding patients with missing data, we had an analytical sample of 15,877 patients. Data were analysed using negative binomial regression and logistic regression models depending on the outcome variable. Results Patients had a mean activation score of 55.1 and a standard deviation (SD) of 17.7 (range: 0–100). They had an average of 5.4 GP visits (SD = 8.0), 26.8 non-GP visits (SD = 23.4) and 6.0 outpatient attendances (SD = 7.9) within a one-year follow-up. About 24.7% patients had at least one elective admission, 24.2% had one or more emergency admissions, and 42.3% had one or more A&E attendance within the follow-up. After accounting for a number of demographic and health factors, we found a linear (or proximately linear) association between patient activation and the number of GP visits, emergency admissions and A&E attendance, but a non-linear relationship between patient activation and the number of non-GP visits, the number of outpatient attendance and elective inpatient admission. Conclusions This study has provided strong empirical evidence from England linking patient activation with healthcare service utilisation. It suggests the value of supporting patient activation as a potential pathway to ease the burden of healthcare system.

scholarly journals LO53: Emergency department visits for hyperglycemia: through the eyes of the patient

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S26-S26
Author(s):  
J. Yan ◽  
D. Azzam ◽  
S. Liu ◽  
T. Spaic ◽  
M. Columbus ◽  
...  
Keyword(s):  
Emergency Department ◽  
Glycemic Control ◽  
Patient Experience ◽  
Diabetes Care ◽  
Symptom Relief ◽  
Tertiary Care ◽  
Emergency Department Visits ◽  
Comparative Approach ◽  
Post Discharge

Introduction: Patients with poorly-controlled diabetes often visit the emergency department (ED) for treatment of hyperglycemia. While previous qualitative studies have examined the patient experience of diabetes as a chronic illness, there are no studies describing patients’ perceptions of ED care for hyperglycemia. The objective of this study was to explore the patient experience regarding ED hyperglycemia visits, and to characterize perceived barriers to adequate glycemic control post-discharge. Methods: This study was conducted at a tertiary care academic centre in London, Ontario. A qualitative constructivist grounded theory methodology was used to understand the experience of adult patient partners who have had an ED hyperglycemia visit. Patient partners, purposively sampled to capture a breadth of age, sex, disease and presentation frequency were invited to participate in a semi-structured individual interview to probe their experiences. Sampling continued until a theoretical framework representing key experiences and expectations reached sufficiency. Data were collected and analyzed iteratively using a constant comparative approach. Results: 22 patients with type 1 or 2 diabetes were interviewed. Participants sought care in the ED over other options because of their concern of having a potentially life-threatening condition, advice from a healthcare provider or family member, or a perceived lack of convenient alternatives to the ED based on time and location. Participants’ care expectations centred around symptom relief, glycemic control, reassurance and education, and seeking referral to specialist diabetes care post-discharge. Finally, perceived system barriers that challenged participants’ glycemic control included affordability of medical supplies and medications, access to follow-up and, in some cases, the transition from pediatric to adult diabetes care. Conclusion: Patients with diabetes utilize the ED for a variety of urgent and emergent hyperglycemic concerns. In addition to providing excellent medical treatment, ED healthcare providers should consider patients’ expectations when caring for those presenting with hyperglycemia. Future studies will focus on developing strategies to help patients navigate some of the barriers that exist within our current limited healthcare system, enhance follow-up care, and improve short- and long-term health outcomes.

A Survey of the Use of Self-Acupuncture in Pain Clinics - a Safe Way to Meet Increasing Demand?

2004 ◽  
Vol 22 (3) ◽  
pp. 137-140 ◽  
Author(s):  
Michele Orpen ◽  
Gale Harvey ◽  
Jeff Millard
Keyword(s):  
Waiting Time ◽  
Patient Selection ◽  
Acupuncture Treatment ◽  
Pain Clinic ◽  
Use Of Self ◽  
Average Waiting Time ◽  
Pain Clinics ◽  
Increasing Demand ◽  
Published Research

An acupuncture service is well established within a pain clinic in Nottingham, England, and is now unable to meet the increasing demand for treatment despite recent expansion. Patients used to be offered training in self-acupuncture. This was withdrawn because of safety concerns, but is being considered again as a way of meeting the demand. There is little published research on the topic, so a survey of 42 English hospitals was conducted to establish whether acupuncture services are provided, and to discover whether others were offering training in self-acupuncture to patients. Thirty hospitals replied, 23 of which offer an acupuncture service. The average waiting time for the first acupuncture treatment was 18.5 weeks, and the average waiting time for follow up treatments was nine weeks. One hospital taught patients auricular self-acupuncture, another was planning to teach patients, and a third hospital had previously taught patients but stopped. Discussing these findings, concerns are raised about the safety of self-acupuncture, and issues about patient selection, training, information, supervision and supply of materials are reviewed. A debate on these issues would be valuable.

scholarly journals The Effect of Drug Types, Facility, and Infrastructure against the Waiting Times at the Pharmacy Installation of Caruban General Hospital

2021 ◽  
Vol 4 (2) ◽  
pp. 204-210
Author(s):  
Farid Amirudin ◽  
Koesnadi Koesnadi
Keyword(s):  
Waiting Time ◽  
Quantitative Research ◽  
Waiting Times ◽  
Sampling Technique ◽  
Total Sample ◽  
Initial Study ◽  
Pharmacy Service ◽  
Waiting Room ◽  
Average Waiting Time ◽  
Long Time

Backgorund. Waiting time is one indicator of pharmacy service. The initial study with 5 patients in the pharmacy installation, of Caruban Hospital, concluded that all patients stated that they were tiring and queued for a long time. This study aims to examine whether there is an effect of type of drug, facility, and infrastructure to waiting time to get pharmacy service at Caruban Regional Public Hospital. The Design of this research used quantitative research The sampling technique was purposive sampling with total sample are 100 respondents. The statistical analysis used dummy regression. The average waiting time for pharmacy service is about 60 minutes for concocted drug, Average waiting time for packaged drugs is 46.5 minutes, and mixed drug is 69.5 minutes. 72 respondents stated that the infrastructure was in the good category and the rest said it was moderate.The results of the dummy regression analysis concluded that facilities and infrastructure had a significant effect simultaneously on the waiting time for services. The partial test results showed that the significance value for the facilities and infrastructure variable was 0.000, and for the variable dosage forms in mixed prescriptions it had a significance value of 0.023. The means variable is the variable that most influences the waiting time for the prescription service. The types of drugs in the prescription and waiting room infrastructure have a significant effect simultaneously on the length of queuing for drugs.

scholarly journals Reducing Waiting Time in the General Pediatric Clinic at Al Wakra Hospital, Qatar

2022 ◽  
Vol 5 (1) ◽  
pp. 01-10
Author(s):  
Sara Kazkaz ◽  
Ghadeer Mustafa ◽  
Almunzer Zakaria ◽  
Muna Atrash ◽  
Ayman Tardi ◽  
...  
Keyword(s):  
Public Health ◽  
Quality Improvement ◽  
Waiting Time ◽  
Pediatric Population ◽  
Waiting Times ◽  
Outpatient Department ◽  
Predictive Tool ◽  
Improvement Project ◽  
Average Waiting Time ◽  
Pediatric Clinic

Background: Waiting times for clinic appointments constitute a key indicator of an outpatient department performance for access to care and patient satisfaction. This is particularly relevant for pediatric population. The Ministry of Public Health in Qatar set a waiting time of 28 days for patients to get new appointment in General Outpatient Department (GOPD). The current average waiting time to get a new appointment in the general pediatric clinic (GPC) at AWH is 57 days. Aim: Decrease the average waiting time to get a new clinic appointment from 57 days to 28 days by the end of December 2018, and to meet the national targets set by the Ministry of Public Health. Methodology: This is a Quality Improvement (QI) project using the Model for Improvement (MFI). The MFI framework is designed to support organizations answering fundamental questions before agreeing on drivers for change. The implementation of change was be facilitated by the Plan-Do-Study-Act (PDSA) cycles methodology. The QI project team performed a root cause analysis using the Ishikawa diagram and identified the key contributing factors to the long waiting times to get a new appointment. Twenty-seven PDSA cycle ramps were designed with support of predictive tool to test innovative changes in current operational processes in an attempt to improve waiting time in the general pediatric clinic at Al Wakra Hospital. Results: The monthly average number of referrals for GPC increased by 200% between the pre and post implementation periods. The average triage waiting time improved from 6 to 2.6 days in 2018 and the average become 1 day in 2019. Post-implementation the average waiting time for patients to get new appointment improved from 57 days to 28 days in 2018 and the average waiting time improved to 16 days in 2019. Conclusion: The quality improvement project for the AWH general pediatric clinic demonstrates significant improvement in waiting times for new appointments, the recommendation for the hospital leadership would be to rollout the improvement methodology to other clinics that suffer from similar challenges.

scholarly journals An audit of waiting times at a specialist psychotherapy service

2006 ◽  
Vol 30 (5) ◽  
pp. 182-184 ◽  
Author(s):  
Ged Garry ◽  
Graham Paley
Keyword(s):  
Service Delivery ◽  
Waiting Time ◽  
Action Plan ◽  
Waiting Times ◽  
Clinical Implications ◽  
Audit Process ◽  
Average Waiting Time ◽  
Mean Waiting Time ◽  
The Mean ◽  
Using Data

Aims and MethodReferrals to a specialist psychotherapy service were audited to measure the average waiting time for a first appointment and the proportion of patients waiting longer than 13 weeks. Recommendations for improving service delivery were made, an action plan implemented and the audit repeated.ResultsIn 2003, an initial audit of 355 referrals was completed using data from 2002. This found a mean waiting time to first appointment of 11.5 weeks with 30% of patients waiting longer than 13 weeks. In 2004, following implementation of the action plan, a re-audit of 200 patients found that the mean waiting time from receipt of referral to first appointment had reduced to 6.7 weeks with only 2.3% waiting more than 13 weeks.Clinical ImplicationsAudit can improve the efficiency of service delivery in a specialist psychotherapy service. However, this may require that psychotherapists review traditional ways of working. Also, it is important that they feel personally involved in the audit process.

Sign in / Sign up

Export Citation Format

Share Document