Decreasing extremes in patient waiting time
| Autor: | E. J. Mayeaux, Lynn J. Groome |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
Waiting time
medicine.medical_specialty Health (social science) Time Factors Waiting Lists Leadership and Management Efficiency Organizational Ambulatory Care Facilities Pregnancy Outpatient setting Medicine Outpatient clinic Humans In patient Prospective Studies Prospective cohort study Care Planning business.industry Health Policy Wait time Causality Obstetrics Schedule (workplace) Emergency medicine Female business Root cause analysis Algorithms |
| Zdroj: | Quality management in health care. 19(2) |
| ISSN: | 1550-5154 |
| Popis: | INTRODUCTION We present a conceptual framework for approaching reducing excessive patient wait time in an outpatient setting. We hypothesized that statistical process control techniques can be used to identify extremes in waiting time; root cause analysis can be used to identify specific delay causes; and minimizing the contribution of the root causes will lead to an improvement in system performance. SUBJECT AND METHOD We conducted a prospective study of waiting times in a private outpatient clinic providing high-risk obstetrical care. The baseline period consisted of 55 clinic sessions, and the intervention period consisted of 101 clinic sessions. RESULTS Mean waiting time was prolonged during 9 (16.4%) baseline clinic sessions. The root cause analysis determined that appointment schedule, physician tardiness, and patient complexity contributed to clinic delays. After making changes to minimize root causes, there was a significant reduction in prolonged waiting times (16.4% vs 4.9%, Yates chi(2) = 4.37, P = .037); a significant decrease in mean waiting time (32.7 +/- 23.6 minutes vs 29.3 +/- 21.2 minutes, t = 3.42, P < .001); and a significant improvement in the waiting time distribution (Kruskal-Wallis test of homogeneity, P = .003). CONCLUSIONS Our methodology was successful in identifying and reducing factors associated with prolonged wait times. However, although system operation was improved, as defined by a decrease in the occurrence of excessive clinic delays, effecting a large and sustained decrease in patient waiting times was challenging. |
| Databáze: | OpenAIRE |
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