scholarly journals Orthopaedic Waiting List Reduction through a Review of Service Provision: The Problems Encountered

1988 ◽  
Vol 81 (8) ◽  
pp. 445-447 ◽  
Author(s):  
V K Hochuli
Keyword(s):  
Service Provision ◽  
Inpatient Treatment ◽  
Waiting Times ◽  
Working Party ◽  
Waiting List ◽  
Reliable Information ◽  
Accurate Information ◽  
Surgical Service ◽  
Prevention Strategies ◽  
Outpatient Appointments

Measures to eliminate excessive waiting times for orthopaedic outpatient appointments and inpatient treatment were proposed by a Working Party under the chairmanship of Professor R B Duthie. To implement the proposals reliable information is necessary but a survey in a district found that waiting list numbers were inaccurate, activity statistics under represented work levels and there was scepticism about the accuracy of theatre records. With accurate information and use of the proposed methods a service's efficiency should increase, but problems will remain unless measures of outcome, control of input and accident prevention strategies are devised. In the meantime good management of waiting lists will improve the quality and efficiency of a surgical service.

HOW TO REPORT AND MONITOR THE PERFORMANCE OF WAITING LIST MANAGEMENT

2002 ◽  
Vol 18 (3) ◽  
pp. 611-618
Author(s):  
Markus Torkki ◽  
Miika Linna ◽  
Seppo Seitsalo ◽  
Pekka Paavolainen
Keyword(s):  
Hallux Valgus ◽  
Waiting Time ◽  
Varicose Vein ◽  
Elective Surgery ◽  
Waiting Times ◽  
Waiting List ◽  
Mean Waiting Time ◽  
Number Of Patients ◽  
Potential Problems ◽  
Queue Discipline

Objectives: Potential problems concerning waiting list management are often monitored using mean waiting times based on empirical samples. However, the appropriateness of mean waiting time as an indicator of access can be questioned if a waiting list is not managed well, e.g., if the queue discipline is violated. This study was performed to find out about the queue discipline in waiting lists for elective surgery to reveal potential discrepancies in waiting list management. Methods: There were 1,774 waiting list patients for hallux valgus or varicose vein surgery or sterilization. The waiting time distributions of patients receiving surgery and of patients still waiting for an operation are presented in column charts. The charts are compared with two model charts. One model chart presents a high queue discipline (first in—first out) and another a poor queue discipline (random) queue. Results: There were significant differences in waiting list management across hospitals and patient categories. Examples of a poor queue discipline were found in queues for hallux valgus and varicose vein operations. Conclusions: A routine waiting list reporting should be used to guarantee the quality of waiting list management and to pinpoint potential problems in access. It is important to monitor not only the number of patients in the waiting list but also the queue discipline and the balance between demand and supply of surgical services. The purpose for this type of reporting is to ensure that the priority setting made at health policy level also works in practise.

scholarly journals The Surgical Care Practitioner: A Feasible Alternative. Results of A Prospective 4-Year Audit at St Mary's Hospital Trust, London

2007 ◽  
Vol 89 (1) ◽  
pp. 30-35 ◽  
Author(s):  
Shirley Martin ◽  
Sanjay Purkayastha ◽  
Rachel Massey ◽  
Paraskevas Paraskeva ◽  
Paris Tekkis ◽  
...  
Keyword(s):  
Waiting Times ◽  
Surgical Care ◽  
Wound Dehiscence ◽  
General Anaesthetic ◽  
Surgical Service ◽  
Allied Health Professions ◽  
Short Course ◽  
Patient Questionnaires ◽  
Feasible Alternative ◽  
A Minor

INTRODUCTION Surgical care practitioners (SCPs) are an expanding group of professionals, drawn from nursing and the allied health professions. Amongst other functions, SCPs can provide a range of surgical procedures including a ‘minor surgical’ service. The aim of this study was to audit the volume and outcomes related to the SCP service at St Mary's since its inception. PATIENTS AND METHODS All prospectively collected data regarding SCP-managed patients between 2001 and 2005 were retrospectively audited. Volume, case mix, waiting times, complications and patient satisfaction were recorded and evaluated. RESULTS In this 4-year period, the SCP performed 381 minor operative cases (year 1 to year 4: 32, 74, 114 and 161 cases, respectively). These included excision of lipomas, sebaceous cysts and suspicious naevi under local anaesthesia and 7 similar cases under general anaesthetic. There were 11 minor postoperative complications which included 7 wound infections which were all resolved with a short course of oral antibiotics, 2 seromas of which one needed aspiration under local anaesthetic and one minor wound dehiscence which was re-sutured the same day. Overall, 71% were seen within 1 month of referral, 16% within 1–2 months, 3% within 3 months and 10% within 6 months. In addition, 59% were seen and treated within 20 min of their appointed time, 15% within 30–60 min and 24% within 1–2 h. The 3-month patient perspective audit carried out between May and July 2004 included 59 completed patient questionnaires following surgery; 100% were totally satisfied with the care that they received; 98% were happy to see the SCP and 98% documented that they would recommend the SCP to others. CONCLUSIONS The 4-year period of using an SCP at St Mary's shows that it is feasible and safe for minor operative procedures, that it contributes positively to waiting times and is acceptable to patients.

scholarly journals RADIOGRAPHIC IMPLICATIONS OF THE SURGICAL WAITING LIST FOR THE TREATMENT OF SPINAL DEFORMITY

2018 ◽  
Vol 17 (1) ◽  
pp. 19-22
Author(s):  
LEONARDO YUKIO JORGE ASANO ◽  
MARINA ROSA FILÉZIO ◽  
MATEUS PIPPA DEFINO ◽  
VINÍCIUS ALVES DE ANDRADE ◽  
ANDRÉ EVARISTO MARCONDES CESAR ◽  
...  
Keyword(s):  
Surgical Planning ◽  
Negative Impact ◽  
Waiting Times ◽  
Waiting List ◽  
Surgical Morbidity ◽  
Level Of Evidence ◽  
Mean Waiting Time ◽  
Significant Negative Impact ◽  
Double Approach ◽  
The Mean

ABSTRACT Objective: The aim of this study was to evaluate the implications of long waiting times on surgery lists for the treatment of patients with scoliosis. Methods: Radiographs of 87 patients with scoliosis who had been on the waiting list for surgery for more than six months were selected. Two surgeons answered questionnaires analyzing the radiographs when entering the waiting list and the current images of each patient. Results: Data from 87 patients were analyzed. The mean waiting time for surgery was 21.7 months (ranging from seven to 32 months). The average progression of the Cobb angle in the curvature was 21.1 degrees. Delayed surgery implied changes in surgical planning, such as greater need of instrumentation, osteotomies, and double approach. Conclusions: Long waiting lists have a significant negative impact on surgical morbidity of patients with scoliosis, since they increase the complexity of the surgery. Level of evidence: IV. Type of study: Descriptive study.

THUR 122 Parkinson’s kinetigraph improves movement disorder service provision

2018 ◽  
Vol 89 (10) ◽  
pp. A13.3-A13
Author(s):  
Kobylecki Christopher ◽  
Partington-Smith Lucy ◽  
Silverdale Monty
Keyword(s):  
Movement Disorder ◽  
Service Provision ◽  
Clinical Decision Making ◽  
Hospital Admissions ◽  
Clinical Decision ◽  
Objective Evaluation ◽  
Advanced Therapies ◽  
Subsequent Effect ◽  
Outpatient Appointments ◽  
Deep Brain

IntroductionObjective evaluation of symptoms of Parkinson’s disease (PD) can be challenging. There is increasing interest in technological solutions to assess, monitor and manage people with PD.ObjectiveTo evaluate the effect of the Parkinson’s Kinetigraph (PKG) on management of patients with PD in a large tertiary movement disorder service.MethodsWe retrospectively reviewed the notes of 47 patients with PD (22 female, 25 male) who underwent PKG recording over a six month period. The indications and PKG findings, and the subsequent effect on clinical decision making and service provision were recorded.ResultsManagement was significantly altered in 25 patients (53%), while in 13 patients (28%) PKG confirmed the use of advanced therapies such as deep brain stimulation. Significant effects were seen with regard to service provision. Outpatient appointments could be deferred with advice following PKG in 15 (32%), advanced therapies assessment was improved in 16 (34%), while inpatient admission was avoided in six patients (13%).ConclusionThe use of PKG has enhanced service provision in our movement disorder service. In particular, it enhances our assessment of patients considered for high-cost advanced therapies, allows more efficient use of clinic appointments, and has the potential to reduce hospital admissions.

Prioritisation of catheterised patients for elective bladder outflow obstruction surgery in the current coronavirus disease 2019 era to reduce catheter-associated morbidity

2020 ◽  
pp. 205141582096403
Author(s):  
Angela Kit Ying Lam ◽  
Kathie Wong ◽  
Tharani Nitkunan
Keyword(s):  
Median Time ◽  
Waiting Times ◽  
Waiting List ◽  
Transurethral Resection Of Prostate ◽  
Outflow Obstruction ◽  
Level Of Evidence ◽  
Bladder Outflow Obstruction ◽  
Patient Demographics ◽  
Accident And Emergency ◽  
Included Patient

Objectives: This study aimed to audit the waiting times for a transurethral resection of prostate (TURP) at our institution, and to evaluate the extent of catheter-associated morbidity in this population. Methods: This was a retrospective closed-loop audit, with cycle one between 1 January 2018 and 31 December 2018 and cycle two between 1 October 2019 and 29 February 2020. Data collected included patient demographics, catheter status, catheter-associated presentations to accident and emergency (A&E), admissions and waiting times for TURP. The waiting-list form now has a catheter box, and a goal of 30 days from waitlisting to operation was set for those catheterised. Results: In cycle 1, 36% of the 181 patients were catheterised, and waited a median of 119 days (interquartile range (IQR) 59–163 days) for their TURP, while those not catheterised waited a median of 118 days (IQR 57.75–188.25 days). Catheterised patients presented to A&E 93 times, resulting in 13 admissions, compared to two presentations and zero admissions for those not catheterised. The median time from catheter insertion to first A&E attendance was 20 days (IQR 2–101 days). In cycle 2, 33% of the 55 patients were catheterised, with the median waiting-list time falling to 32 days (IQR 22–46 days) in those catheterised and 33 days (IQR 20–49 days) in those not catheterised. All 11 A&E attendances were from catheterised patients, with no admissions. The median time from insertion to first A&E attendance was nine days (IQR 4–40 days). Eighty-eight per cent of the waiting-list forms had appropriately ticked the catheter box. Conclusion: Our study shows that catheterised patients awaiting a TURP are more likely to have complications necessitating A&E attendance. Prioritisation of these patients on the waiting list for bladder outflow obstruction surgery may help to reduce catheter-associated morbidity. Level of evidence: Level 2c.

scholarly journals Cross-sectional survey of orthotic service provision in the UK: does where you live affect the service you receive?

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e028186
Author(s):  
Nachiappan Chockalingam ◽  
Nicola Eddison ◽  
Aoife Healy
Keyword(s):  
Outcome Measures ◽  
Service Provision ◽  
Response Rate ◽  
Waiting Times ◽  
Lead Times ◽  
Limited Information ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The Uk

ObjectiveTo investigate the quantity and quality of orthotic service provision within the UK.DesignCross-sectional survey obtained through freedom of information request in 2017.SettingNational Health Service (NHS) Trusts/Health Boards (HBs) across the UK.Main outcome measuresDescriptive statistics of survey results, including information related to finance, volume of appointments, patients and orthotic products, waiting times, staffing, complaints, outcome measures and key performance indicators.ResultsResponses were received from 61% (119/196) of contacted Trusts/HBs; 86% response rate from Scotland (12/14) and Wales (6/7), 60% (3/5) from Northern Ireland and 58% (98/170) from England. An inhouse service was provided by 32% (35/110) of responses and 68% (74/110) were funded by a block contract. Long waiting times for appointments and lead times for footwear/orthoses, and large variations in patient entitlements for orthotic products across Trusts/HBs were evident. Variations in the length of appointment times were also evident between regions of the UK and between contracted and inhouse services, with all appointment times relatively short. There was evidence of improvements in service provision; ability for direct general practitioner referral and orthotic services included within multidisciplinary clinics. However, this was not found in all Trusts/HBs.ConclusionsThe aim to provide a complete UK picture of orthotic service provision was hindered by the low response rate and limited information provided in some responses, with greater ability of Trusts/HBs to answer questions related to quantity of service than those that reflect quality. However, results highlight the large discrepancies in service provision between Trusts/HBs, the gaps in data capture and the need for the UK NHS to establish appropriate processes to record the quantity and quality of orthotic service provision. In addition to standardising appointment times across the NHS, guidelines on product entitlements for patients and their lead times should be prescribed to promote equity.

An audit of the cochlear implant service in Manchester

1996 ◽  
Vol 110 (11) ◽  
pp. 1046-1054 ◽  
Author(s):  
D. J. Mawman ◽  
J. D. Edwards ◽  
E. C. Giles ◽  
D. Y. Aplin ◽  
M. O'Driscoll ◽  
...  
Keyword(s):  
Cochlear Implant ◽  
Cochlear Implants ◽  
Service Provision ◽  
Clinical Care ◽  
Waiting Times ◽  
Auditory Training ◽  
Postoperative Rehabilitation ◽  
Written Information ◽  
Patient Assessments ◽  
Training Exercises

AbstractThe adult cochlear implant programme in Manchester was established in 1988 and the evaluation of the cochlear implant service involved the first 58 implants users (mean age = 51.65 years, range 19–75 years). Questionnaires were sent to implant users and their partners to evaluate the service with regard to provision of information, clinical care during in-patient assessments, waiting times, operation for cochlear implant and postoperative rehabilitation. The results show that the majority of patients (78 per cent) felt that the implant gave them as much or more benefit than expected. Areas identified for improvements include provision of more written information about cochlear implants; reduction in waiting times for first appointments; more information about the surgical risks and more instruction about home auditory training exercises for family and friends.As a consequence of the audit results the clinical practice and service provision for cochlear implantation in Manchester has been modified.

scholarly journals Dangers of long waiting times for outpatient appointments at a urology clinic.

BMJ ◽  
1993 ◽  
Vol 306 (6875) ◽  
pp. 429-429 ◽  
Author(s):  
K German ◽  
F Nuwahid ◽  
P Matthews ◽  
T Stephenson
Keyword(s):  
Waiting Times ◽  
Outpatient Appointments ◽  
Urology Clinic

OIL SPILL DATABASES: DEVELOPING PREVENTION STRATEGIES ACROSS STATE LINES

1997 ◽  
Vol 1997 (1) ◽  
pp. 539-543 ◽  
Author(s):  
Gary L. Gregory ◽  
Richard W. Holly ◽  
Megan Thomas
Keyword(s):  
Oil Spill ◽  
Human Error ◽  
Oil Spills ◽  
Washington State ◽  
Accurate Information ◽  
Prevention Strategies ◽  
Causal Information ◽  
Reporting Requirements ◽  
Marine Safety ◽  
Share Information

ABSTRACT This paper details the process used by two states, California and Washington, to develop common reporting of oil spill causes. Many different agencies use databases to store oil spill information, but there is a general lack of standardization in reporting requirements, making it difficult to share information. Many of these databases only reflect initial spill reports, and few contain information on spill causes that could be used to prevent oil spills from occurring. Washington State's Office of Marine Safety (OMS) has developed an extensive database that includes spill and casualty information from vessels transiting Washington state waters. California State Lands Commission, Marine Facilities Division (MFD), has similarly developed an oil spill database for marine terminals in the state of California. What makes these systems unique is that they attempt to integrate reliable, accurate information on incident causes, paying particular attention to human error. Both agencies have joined together in a pilot program to share oil spill causal information using common terms. This paper addresses the approach used to establish common data dictionaries, oil spill report formats, and a methodology to determine causal information. California and Washington are currently working with other states and British Columbia to develop common reporting throughout the West Coast. The information collected and shared can be used by each jurisdiction to develop appropriate prevention strategies.

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