Reducing Waiting Time for Orthopaedic Consultation Through a Continuous Improvement Approach

Abstract

The outpatient service of public hospitals has had many difficulties in responding to the high demand that are being subjected to. The waiting times for a medical appointment are well above the clinically recommended waiting time, compromising the patients' health status. To combat this trend, health authorities have set the maximum response time for consultations, financially penalizing hospitals for not meeting these times. However, these penalties only act as an additional problem for hospitals. Given the relevance of improving the care performance provided to patients, in terms of quality and celerity, this article presents the study carried out at the outpatient service of a Portuguese hospital. This study presents a set of actions implemented as the result of a simple Continuous Improvement (CI) approach. That CI approach was inspired on Toyota Kata and the results obtained are translate into a reduction of the waiting time for triage by 90% and the waiting time for the first orthopaedic consultation by 27%, for average values in days. The implemented actions were also planned to promote in the long term an increase in the availability of the service, allowing an additional reduction in the waiting time for consultation.