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

Abstract

Background: Patient clinic waiting times are an important indicator of quality of services offered by hospitals. Long waiting times are a major source of patient dissatisfaction and adversely affect patient compliance with treatment regimes and clinical outcomes. Cancer patients require longer consultation times, which have a build up effect of increasing waiting times of the other patients needing to be seen.Methods: We performed an audit of all patients who presented to the Maxillofacial/Head and Neck clinics in May 2008 at the Royal Darwin Hospital. Patients who arrived late for their scheduled appointment were excluded. Recommendations from the audit were implemented and a re audit done after six months. Based on the analyses of the initial results, our service was re organised into separate cancer and non-cancer clinics. A follow up audit was done six months later in November 2008. Patients were pre selected randomly from the out patient clinic list of both cancer and non-cancer clinics. Patients who arrived late for their scheduled appointment were excluded. Data was summarised with graphs and tables and statistical analyses done using XLSTAT version 2008.6.8 Copyright Addinsoft 1995-2008 software.Results: 75 patients were analysed for the audit and 45 for the re -audit. About a third of patients from both studies were cancer patients; 37.8% of the audit and 34% in the re audit. Mean clinic waiting time in the audit was 42.89minutes. There was a statistically significant difference in consultation times (p<.001) at 95% Confidence interval (CI) with initial cancer visits spending the most time (70.8 minutes) and follow up non cancer patients spending the least time (16.2minutes). In the reaudit, the mean waiting time was reduced to 12 minutes and there was still a statistically significant difference in consultation times (p<.001) at 95% CI with initial cancer visits spending the most time (63.7 minutes) and follow up non cancer patients spending the least time (11.72minutes). In both the audit and re audit, there was no statistically significant difference in the time spent on procedures. Conclusion: Separating outpatients into cancer clinics and non-cancer clinics is a cost effective way of reducing clock waiting times in outpatient clinics and thus improving the quality of care to our patients.