A cost effective way of reducing outpatient clinic waiting times: How we did it

10.5580/22aa ◽  
2010 ◽  
Vol 7 (1) ◽  
Keyword(s):  
Outpatient Clinic ◽  
Waiting Times ◽  
Cost Effective

scholarly journals Improving waiting times in the orthopaedic outpatient clinic

2017 ◽  
Vol 6 (2) ◽  
pp. e000067
Author(s):  
Julia Street ◽  
Wajeeha Khan ◽  
Aureola Tong ◽  
Vasudev Shanbhag
Keyword(s):  
Outpatient Clinic ◽  
Waiting Times

scholarly journals Patient satisfaction at haematology and oncology clinics in the Free State & Northern Cape

Curationis ◽  
2002 ◽  
Vol 25 (2) ◽  
Author(s):  
W.R. Davies ◽  
D.P. Hepburn ◽  
M.J. Coetzee ◽  
P.N. Badenhorst ◽  
L. Goedhals ◽  
...  
Keyword(s):  
Waiting Times ◽  
Cost Effective ◽  
Free State ◽  
Female Ratio ◽  
Medical Needs ◽  
Non Governmental Organizations ◽  
Service Staff ◽  
Northern Cape ◽  
The Government ◽  
Mode Of Transport

The Free State and Northern Cape make up some 40% of the land area of South Africa, while being home to only 10% of the total population. Haematology and Oncotherapy outreach clinics were established in Kimberley, Bethlehem and Welkom to provide a more accessible service to the thinly spread population. A previous study showed these clinics to be cost-effective, but we had no idea how the patients experience them. Our aim was to obtain information about the demographics of the patients, the logistical support of the clinics, the medical needs of the patients and how they experience the clinics. This can help us to improve the service. A questionnaire was tested in a pilot study. The demographic questions covered age, sex and ethnicity. The logistical questions dealt with distance travelled to the clinic, mode of transport, length of time as a patient and cost. The medical need questions dealt with type of disease, treatment received, type of doctor seen and origin of referral. The questions about experience covered satisfaction with the service, staff, waiting times and involvement of non-governmental organizations. Of the 95 patients interviewed 42% were from the haematology clinics. The mean age was 59.5 and the male: female ratio was 0.6:1. Forty-six percent of the patients spoke Afrikaans and 31 % spoke South Sotho. The black:white ratio was 1:1. Twenty-eight percent used the government ambulances (of whom 80% were satisfied) and 56% used their own cars. The median payment at a clinic was R20 (R0 to R200). Only 19% of patients were paying privately. Ninety-five percent of the patients were follow-ups, with the median length of follow-up being 24 months (1 to 468). The patients were mainly referred by local hospitals. Twentytwo percent of the patients had chronic haematological malignancies, while 68% had solid tumours. Thirty-seven percent of the patients received drugs to take home and only 6% got intravenous chemotherapy. Consultants saw 44% of the patients. The median waiting time to be seen was 1.5 hours (0 to 5). Consultation time averaged 10 minutes and most patients were satisfied with this. Despite the study’s small size the system of outreach clinics seems to be delivering a satisfactory service. Criticisms were few. However there were suggestions to create better clinic facilities and to shorten the waiting times at the clinic.

scholarly journals Waiting times in an ophthalmic outpatient clinic

BMJ ◽  
1994 ◽  
Vol 309 (6963) ◽  
pp. 1231-1231
Author(s):  
P I Murray
Keyword(s):  
Outpatient Clinic ◽  
Waiting Times

scholarly journals Factors Associated With Patient Waiting Time at a Medical Outpatient Clinic: A Case Study of University of Nairobi Health Services

2021 ◽  
Vol 6 (12) ◽  
pp. 915-918
Author(s):  
Rebecca Bisanju Wafula (BSCN, MSCHSM) ◽  
Dr. Richard Ayah (MBCHB, MSC, PHD)
Keyword(s):  
Health Services ◽  
Health Care Providers ◽  
Waiting Time ◽  
Outpatient Clinic ◽  
Health Workers ◽  
Waiting Times ◽  
Care Providers ◽  
Cross Sectional ◽  
Patient Waiting Time ◽  
Patient Waiting

Background: Long waiting time in outpatient clinics is a constant challenge for patients and the health care providers. Prolonged waiting times are associated with poor adherence to treatment, missed appointment and failure or delay in initiation of treatment and is a major factor towards the perception of the patient towards the care received. Objective: To determine the waiting time and associated factors among out patients attending staff clinic at University of Nairobi health services. Method: A cross-sectional study design was used and data collected from 384 ambulatory patients over a period of four weeks using an interviewer administered pretested structured exit questionnaire with a time-tracking section. Simple random sampling was used to select respondents in a walk- in outpatient clinic set up. Data was cleaned and analysed using Statistical Package for Social Sciences (SPSS) 20. Analysis of variance (ANOVA), and cross tabulation was used to establish associations between the independent variable and dependent variables. Results: In total 384 patients were tracked and interviewed. The average patient waiting time was 55.3mins.Most respondents (52%) suggested that improving availability of staff at their stations would help to reduce patient waiting time. In this study, gender (P=0.005) and availability of doctors (p=0.000) were found to affect patient waiting time with women waiting longer than the male patients. Conclusion: Majority of the patients spent about an hour at the facility to be served. Inadequate number of health workers was the main cause of long waiting time.

scholarly journals Outcomes from the Introduction of a Combined Urology Outpatient Clinic

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Clíodhna Browne ◽  
Catherine M. Dowling ◽  
Patrick O’Malley ◽  
Nadeem Nusrat ◽  
Kilian Walsh ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Outpatient Clinic ◽  
Waiting Times ◽  
Patient Discharge ◽  
Nurse Specialist ◽  
Standard Format ◽  
Team Members ◽  
Hospital Doctors ◽  
One Year ◽  
Urology Clinic

Background. A combined urology clinic staffed by four consultants and four non‐consultant hospital doctors (NCHDs) was introduced in our institution in October 2015. This clinic is supported by a pre‐clinic radiology meeting and a synchronous urology clinical nurse specialist (CNS) clinic with protected uroflow/trial of void slots. Herein, we report on the outcomes of this clinic in comparison with the standard format of urology outpatient review. Methods. We carried out a retrospective review of clinic attendances from May to July 2016. We recorded the number of new and return attendances, which team members had reviewed the patient and patient outcomes. We also calculated the waiting times for new patients to be reviewed in the outpatient clinic. Results. The combined urology clinic reviewed an average of 12 new and 46 return patients per clinic. The standard urology clinic reviewed an average of 8 new and 23 return patients per clinic. 54% of patients were seen by a consultant in the combined urology clinic, and 20% of patients were seen by a consultant in the standard urology clinic. The rate of patient discharge for new patients was 14.8% in the combined clinic compared to 5.9% in the standard clinic. Overall patient outcomes are outlined in the table. The waiting time for review of new patients in the combined clinic was reduced by 39% from 144 days to 89 days over a one-year period. Conclusions. The introduction of a combined urology outpatient clinic with the support of pre‐clinic radiology meeting and synchronous urology CNS clinic facilitates patient discharge.

Increasing efficiency in healthcare: a showcase in an orthopedic outpatient clinic

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Andras Heijink ◽  
Jaap van den Heuvel ◽  
Marit Schoonhoven
Keyword(s):  
Outpatient Clinic ◽  
Cost Effective ◽  
Lean Six Sigma ◽  
Fixed Amount ◽  
Content Type ◽  
Pareto Analysis ◽  
Orthopedic Surgeons ◽  
Current Topic ◽  
Hospital Visits ◽  
The Given

Purpose Cost reduction is a current topic within healthcare. This article aims to show how Lean Six Sigma can be applied to make the orthopedic outpatient clinic within a hospital more cost-effective. The approach can, of course, also be applied to other departments. Design/methodology/approach We did a pareto analysis to select the project with the greatest potential. The most expensive and time-consuming activity is repeat consultations; these number around 7,500 per year and are all performed by the orthopedic surgeon. This limits the number of appointments available for new patients. Moreover, the hospital gets a fixed amount of money for each new patient. Therefore, reducing the number of repeat consultations is beneficial to both the patient and the hospital. Findings Based on data analysis, we found that the number of repeat consultations performed by orthopedic surgeons can be reduced by 19.5%. An additional 10.8% can be performed by phone, which will probably save the surgeons considerable time. The freed-up time can be used for new patients. Another result is that hospital visits by patients for repeat consults can be reduced by 20.3%. We believe that these efficiency improvements are also possible for other departments/processes. Finally, in the given case, the freed-up time for new patients could generate 465K euros. Originality/value This article shows that 20% of the care provided by the physicians (i.e. repeat consults) is omissible. While most projects focus on doing the same number of activities in a more efficient way, this paper shows that it is also possible to reduce the amount of medical care provided. We believe that it would be beneficial to take such a perspective when looking at other processes and departments within healthcare.

The Efficiency of Specialist Outreach Clinics in General Practice: Is Further Evaluation Needed?

1997 ◽  
Vol 2 (3) ◽  
pp. 174-179 ◽  
Author(s):  
Toby Gosden ◽  
Mary Black ◽  
Nicola Mead ◽  
Brenda Leese
Keyword(s):  
General Practice ◽  
Pilot Study ◽  
Resource Use ◽  
Waiting Times ◽  
Cost Effective ◽  
Outpatient Clinics ◽  
Costs And Benefits ◽  
Number Of Patients ◽  
Outreach Clinic ◽  
Using Data

Objectives: To assess the need for further evaluation of general practice-based outreach clinics in two specialties using data from a UK pilot study to model their cost-effectiveness. Methods: A pilot study was undertaken comparing one outreach and one outpatient clinic held by three dermatology specialists and three orthopaedic specialists. Information was collected on waiting times, costs to patients, casemix and resource use. Results: Only dermatology outreach clinic patients experienced significantly shorter waiting times for first appointments than their hospital counterparts. Outreach clinic patients incurred lower costs in attending appointments in either specialty but the differences were not statistically significant. Evidence of a difference in casemix between patients attending outreach and outpatient clinics meant that treatment costs incurred in both types of clinic could not be compared. Outreach clinics in both specialties were significantly more costly in terms of staff, staff travel and associated opportunity costs compared with outpatient clinics. Sensitivity analysis showed that outreach and outpatient clinics had the same marginal cost if the number of patients per outreach clinic increased greatly or attendance fell considerably at outpatient clinics. Conclusions: This study has found no evidence that outreach clinics in these two specialties are cost-effective in terms of costs and benefits. A more definitive conclusion could only be made if studies estimated other costs and benefits not accounted for in this study. Further research is required to see whether outreach clinics in other specialties or clinics with different configurations to those studied are efficient.

Virtual stone clinic – the future of stone management?

2018 ◽  
Vol 11 (5) ◽  
pp. 361-367 ◽  
Author(s):  
Thomas Smith ◽  
Ola Blach ◽  
Stephanie Baker ◽  
Leanne Newman ◽  
Katherine Guest ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Waiting Times ◽  
Emergency Admission ◽  
Cost Effective ◽  
Stone Disease ◽  
University Hospitals ◽  
Level Of Evidence ◽  
Significant Challenge ◽  
Cost Effective Method ◽  
Urinary Tract Stones

Objectives: Increasing demands on the urology outpatient department at Brighton and Sussex University Hospitals (BSUH) have posed a significant challenge on the provision of a timely service for patients with stone disease. This study aimed to evaluate the patient outcomes and waiting times achieved with a newly implemented virtual stone clinic (VSC). Materials and methods: All new stone referrals received between August 2016 to January 2017 at BSUH were discussed in the VSC. Patients were reviewed within seven days of referral by a multidisciplinary team led by a consultant stone surgeon. A prospectively collected database was generated with primary outcomes including discharge to primary care, need for further diagnostics, re-review at VSC, direct booking for treatment and referral to a traditional outpatient stone clinic. Waiting times between the VSC and previously used outpatient stone clinic were also compared. Results: A total of 526 cases were reviewed in the VSC. One-quarter of patients were discharged following initial VSC review with a further two-thirds discharged after re-review. Treatment was offered to 101 patients, primarily in the form of lithotripsy (65%). Eighty-six patients required formal outpatient clinic appointments. Waiting lists for stone appointments were cleared within two months of implementation of the VSC. Outcomes were very favourable, with only three patients requiring emergency admission for management of their stone disease. Conclusion: The VSC model provides a clinically and cost-effective method of managing patients with urinary tract stones with significantly reduced waiting times and overall improved patient satisfaction. Level of evidence: Not applicable for this multicentre audit.

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