A template for reducing ophthalmology outpatient waiting times: community ophthalmic care

ObjectivesMany chronic eye conditions are managed within public hospital ophthalmology clinics resulting in encumbered wait lists. Integrated care schemes can increase system capacity. In order to direct implementation of a public hospital-based integrated eye care model, this study aims to evaluate the quality of referrals for new patients through information content, assess triage decisions of newly referred patients and evaluate the consistency of referral content for new patients referred multiple times.DesignA retrospective and prospective review of all referral forms for new patients referred to a public hospital ophthalmology clinic between January 2016 and September 2017, and September 2017 and August 2018, respectively.SettingA referral-only public hospital ophthalmology clinic in metropolitan Sydney, Australia.Participants418 new patients on existing non-urgent wait lists waiting to be allocated an initial appointment, and 528 patients who were newly referred.Primary and secondary outcome measuresThe primary outcome was the information content of referrals for new patients. The secondary outcomes were triage outcomes for new incoming referrals, and the number of new patients with multiple referrals.ResultsOf the wait-listed referrals, 0.2% were complete in referral content compared with 9.8% of new incoming referrals (p<0.001). Of new incoming referrals, 56.7% were triaged to a non-urgent clinic. Multiple referrals were received for 49 patients, with no change in the amount of referral content.ConclusionsMost referrals were incomplete in content, leading to triage based on limited clinical information. Some new patients were referred multiple times with their second referral containing a similar amount of content as their first. Lengthy wait lists could be prevented by improving administrative processes and communication between the referral centre and referrers. The future implementation of an integrated eye care model at the study setting could sustainably cut wait lists for patients with chronic eye conditions.

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Australian Caregivers’ Experiences of Paediatric Wait times for Primary and Allied Healthcare Appointments: A Scoping Review

Parry,

Ahad,

Willis

et al. 2024

Health & Social Care in the Community

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Background. Paediatric patients in Australia experience lengthy wait times for Primary and Allied Healthcare Service (PAHCS) appointments. This results in a lack of satisfaction and adverse health outcomes. However, very few studies have explored wait times for appointments with PAHCSs in Australia. This study explored the length of wait time and associated barriers to timely access to paediatric PAHCSs in Australia. Methods. The scoping review followed PRISMA‐ScR guidelines for Preferred Reporting Items for Systematic Reviews and Meta‐Analyses. We comprehensively searched for relevant studies from five databases, including Scopus, Emcare, Medline (via Ovid), CINAHL, and Google Scholar in August 2023 without any time limitations. Studies that reported qualitative findings on the wait times and associated barriers to timely accessing to PAHCSs were selected in this scoping review. We performed a reflexive thematic analysis using NVivo software in this review. Results. A total of seven studies out of ninety‐one retrieved records were eligible to be included in this review. Studies show that Australian children, in general, had to wait more than one year for health assessments and interventions in PAHCSs. The long waiting times were perceived as frustrating and worrying by caregivers of children. Several overarching themes related to the barriers of timely accessing to paediatric PAHCSs in Australia were identified, such as strict appointment criteria for children, disparity between demand and provision, parental unawareness, and inadequate public funding in rural PAHCSs. Conclusion. Australian paediatric patients are severely burdened with long wait times for appointments with PAHCSs, primarily, due to the poor government initiatives in rural PAHCSs. This study suggested that the criteria for booking an appointment in PAHCSs need to be simplified. Besides, adequate public health funding and the provision of resources are required in rural PAHCSs.

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A template for reducing ophthalmology outpatient waiting times: community ophthalmic care

Abstract: By facilitating direct listing of some of the surgical patients to the hospital theatre list, 89.8% of the 996 referrals received treatment without needing to attend the hospital outpatients department.

Cited by 3 publications

References 2 publications

Impact of Community Eye Clinics (CEC) on Specialist Eye Clinic Referrals

Impact of Community Eye Clinics (CEC) on Specialist Eye Clinic Referrals

Review of referrals reveal the impact of referral content on the triage and management of ophthalmology wait lists

Australian Caregivers’ Experiences of Paediatric Wait times for Primary and Allied Healthcare Appointments: A Scoping Review

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