Abstract
BackgroundIt is globally agreed that a well-designed health system deliver timely and convenient access to health services for all patients. Many interventions aiming to reduce waiting times have been implemented in Chinese public tertiary hospitals to improve patients’ satisfaction. However, few were well-documented, and the effects were rarely measured with robust methods.MethodsWe conducted a longitudinal study of the length of waiting times in a public tertiary hospital in Southern China which developed comprehensive data collection systems. Around an average of 60,000 outpatients and 70,000 prescribed outpatients per month were targeted for the study during Oct 2014-February 2017. We analyzed longitudinal time series data using a segmented linear regression model to assess changes in levels and trends of waiting times before and after the introduction of waiting time reduction interventions. Pearson correlation analysis was conducted to indicate the strength of association between waiting times and patient satisfactions. The statistical significance level was set at 0.05.ResultsThe monthly average length of waiting time decreased 3.49 min (P = 0.003) for consultations and 8.70 min (P = 0.02) for filling prescriptions in the corresponding month when respective interventions were introduced. The trend shifted from baseline slight increasing to afterwards significant decreasing for filling prescriptions (P =0.003). There was a significant negative correlation between waiting time of filling prescriptions and outpatient satisfaction towards pharmacy services (r = −0.71, P = 0.004).ConclusionsThe interventions aimed at reducing waiting time and raising patient satisfaction in Fujian Provincial Hospital are effective. A long-lasting reduction effect on waiting time for filling prescriptions was observed because of carefully designed continuous efforts, rather than a one-time campaign, and with appropriate incentives implemented by a taskforce authorized by the hospital managers. This case provides a model of carrying out continuous quality improvement and optimizing management process with the support of relevant evidence.
Highlights
It is globally agreed that a well-designed health system deliver timely and convenient access to health services for all patients
Population and setting The study populations related to waiting times for consultations consisted of all visiting outpatients of the studied hospital during 1 October 2014–28 February 2017, while the study populations related to filling prescriptions included all patients who filled prescriptions from the outpatient pharmacy during 1 March 2015–28 February 2017
The waiting times for consultations ranged between 20.88–23.92 min during October 2014–August 2015, which reduced to a range between 15.83–20.32 min during September 2015–February 2017; and the waiting times for filling prescriptions ranged between 24.91– 42.52 min during March 2015–January 2016, which went down to a range of 14.99–28.77 min during February 2016–February 2017
Summary
It is globally agreed that a well-designed health system deliver timely and convenient access to health services for all patients. Patient waiting time for healthcare services is identified by the World Health Organization (WHO) as one of the key measurements of a responsive health system. The United States (US) Institute of Medicine’s report “Crossing the Quality Chasm” outlines a framework of six guiding principles to staying ahead in a more competitive healthcare delivery system. One of these principles is the ability to provide timely care and to reduce harmful delays [3]. It is globally agreed that a well-designed healthcare service management system should not have patients to wait long time for appointment and consultation
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