Reducing waitlists in outpatient services

Researchers from the Academic and Research Collaborative in Health are investigating how waitlists can be reduced in outpatient settings

Outpatient services – medical treatment provided to non-admitted patients by a hospital or qualified facility – offer care in a range of specialist areas from cardiology to neurology, oncology to rheumatology.

In 2018-2019, 11.1 million specialist outpatient services were provided in Australia.

Demand for specialist care is high, and the wait time from referral to first appointment can be lengthy. Urgent patients are often seen promptly, but patients triaged as low priority may experience delays, which can negatively impact their condition and wellbeing.

Researchers from La Trobe University and Eastern Health are working on a solution, investigating how waitlists can be reduced in outpatient settings.

Using Eastern Health’s Epilepsy Clinic as a case study, the team, led by Annie Lewis, developed a strategy that reduced the Clinic’s waitlist from 599 patients to 24 in just eight months – and with a modest additional budget of just over $10,000.

“The waitlist problem we confronted at the clinic was significant,” says Lewis, “and there was an initial belief that the backlog could only be addressed by funding extra neurologist clinic sessions.”

The research team proved otherwise. Using an iterative process, they determined the needs of each waiting patient by sorting them, not according to priority, but into groups: for discharge, needing a file review by a neurologist, or needing an appointment.

They found that there was a discrepancy between the database and the number of people truly waiting, while phone calls identified patients who no longer required an appointment or were never going to attend.

“Ultimately, only 11% of referrals needed an appointment,” Lewis says, “and at the end of the project there was, essentially, no waitlist.”

The process was developed from the bottom-up, with the clinic manager, neurologists and administrative staff involved.

And while it was a small-scale change, Lewis hopes the project will provide learning to improve the care of people requiring outpatient services.

“Other outpatient clinics may be able to apply this process to reduce their waitlists using a modest budget,” she says. “Now that the backlog has been eliminated, we want to know whether the epilepsy clinic can continue to run without a waitlist. The STAT model, which has worked in allied health and ambulatory care, matches supply and demand for new appointments and encourage clinicians to prioritise ongoing care.”

Read the paper.

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Learn more about the Academic and Research Collaborative in Health (ARCH) and the Eastern Health ARCH.