Generic waiting lists for routine spinal surgery

Leach, Philip; Rutherford, Scott; King, Andrew T.; Leggate, J. R. S.

doi:10.1258/jrsm.97.3.119

Cited by 18 publications

(26 citation statements)

References 1 publication

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“…Of the 13 articles that mentioned this factor [17,18,26,30-39], seven stressed the fact that it can be a major barrier for WTMS implementation [18,26,30,32,33,36,38]. Lack of trust between managers and clinicians was cited as another important factor [17,20,22,25,40] that can have a negative impact.…”

Section: Resultsmentioning

confidence: 99%

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Toward systematic reviews to understand the determinants of wait time management success to help decision-makers and managers better manage wait times

et al. 2013

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BackgroundLong waits for core specialized services have consistently been identified as a key barrier to access. Governments and organizations at all levels have responded with strategies for better wait list management. While these initiatives are promising, insufficient attention has been paid to factors influencing the implementation and sustainability of wait time management strategies (WTMS) implemented at the organizational level.MethodsA systematic review was conducted using the main electronic databases, such as CINAHL, MEDLINE, and Cochrane Database of Systematic Reviews, to identify articles published between 1990 and 2011 on WTMS for scheduled care implemented at the organizational level or higher and on frameworks for analyzing factors influencing their success. Data was extracted on governance, culture, resources, and tools. We organized a workshop with Canadian healthcare policy-makers and managers to compare our initial findings with their experience.ResultsOur systematic review included 47 articles: 36 related to implementation and 11 to sustainability. From these, we identified a variety of WTMS initiated at the organizational level or higher, and within these, certain factors that were specific to either implementation or sustainability and others common to both. The main common factors influencing success at the contextual level were stakeholder engagement and strong funding, and at the organizational level, physician involvement, human resources capacity, and information management systems. Specific factors for successful implementation at the contextual level were consultation with front-line actors and common standards and guidelines, and at the organizational level, financial incentives and dedicated staffing. For sustainability, we found no new factors. The workshop participants identified the same major factors as found in the articles and added others, such as information sharing between physicians and managers.ConclusionsFactors related to implementation were studied more than those related to sustainability. However, this finding was useful in developing a tool to help managers at the local level monitor the implementation of WTMS and highlighted the need for more research on specific factors for sustainability and to assess the unintended consequences of introducing WTMS in healthcare organizations.

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Section: Resultsmentioning

confidence: 99%

“…This factor surfaced as having contributed to the successful implementation of WTMS initiatives [17,22-27,32,34,36,37]. An example of this was consultation with expert panels as part of Ontario’s Wait Time Strategy.…”

Section: Resultsmentioning

confidence: 99%

Toward systematic reviews to understand the determinants of wait time management success to help decision-makers and managers better manage wait times

et al. 2013

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“…On comprehensive management strategies and improvements for surgical pathways, we found five studies . On prioritization of patients on waiting lists, we found one study .…”

Section: Resultsmentioning

confidence: 99%

“…On comprehensive management strategies and improvements for surgical pathways, we found five studies. 21,23,27,28,30 On prioritization of patients on waiting lists, we found one study. 31 For this review, we did find one study that evaluated incentives for using private health insurance schemes with the purpose of reducing public sector waiting lists, 24 another study that evaluated wait time guarantees associated to lump sum supplemental funds compared with years with no additional funding, 26 and a case report on field campaigns to resolve wait lists of a surgical subspecialty.…”

Section: Options To Approach the Problem Of Wait Timesmentioning

confidence: 99%

Policy strategies to reduce waiting times for elective surgery: A scoping review and evidence synthesis

Bachelet

Goyenechea²,

Carrasco

2019

Health Planning & Management

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Summary Objectives The purpose of this evidence‐based review is to identify and describe the interventions that have been implemented to reduce waiting times for major elective surgery. Methods Scoping review and presentation of the results according to the SUPPORT tools. We searched MEDLINE/PubMed, Embase, Cochrane Library, SciELO, DARE‐HTA, and Google Scholar. The inclusion criteria for research design were comprehensive. Results We identified 5200 records. After eliminating duplicates and screening by title and abstract, 171 records remained for full‐text assessment, of which 12 were ultimately included for this review because they reported specific interventions and 96 records were included for further reference. The included studies show significant variability regarding elective procedures, population, and type of provider, as well as in the characteristics of the interventions and the settings. All the studies had methodological limitations. We graded the certainty of the evidence as very low. Conclusions According to the evidence found for this review, interventions most likely should be multidimensional, with prioritization strategies on the waiting lists to incorporate equity criteria, together with quality management improvements of the surgical pathways and the use of operating rooms, as well as improvements in the planning of the surgical schedule.

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“…Lundstrom and others 17 have studied the same problem for the Swedish NHS. Leach and others 3 have introduced a computational system based on clinical aspects to prioritize patients in a waiting list for routine spinal surgery.…”

Section: Review Of Related Previous Researchmentioning

confidence: 99%

Implementing Regulation Policy in Brazilian Health Care Regulation Centers

2009

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The regulation of specialist medical appointments represents one of the problematic areas of the Brazilian Public Health System. In this regulation process, 2 issues stand out: 1) which patients should have the highest attendance priority, and 2) which service suppliers can best resolve the specific health problem of a patient? Based on the consideration of the existing Brazilian context in the field of medical assistance, this study proposes a model designed to aid regulation centers deal with the decisions related to the process of allocating specialist medical appointments. The model integrates multicriteria decision analysis and linear programming for the specialist medical appointment allocation, in which the allocation of patients is defined as a function of the relative significance of a set of criteria related to the notion of effectiveness of the specialist medical care and the capability of the accredited specialist health care units. The integrated model was implemented in a computer-based system and validated using cardiology and vein surgery data from the regulation center in Porto Alegre, Brazil. The validated computational system was applied to mammography services in another regulation center. The system successfully implemented a prioritization scheme, decreasing significantly the examination waiting time of severe cases.

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Generic waiting lists for routine spinal surgery

Cited by 18 publications

References 1 publication

Toward systematic reviews to understand the determinants of wait time management success to help decision-makers and managers better manage wait times

Toward systematic reviews to understand the determinants of wait time management success to help decision-makers and managers better manage wait times

Policy strategies to reduce waiting times for elective surgery: A scoping review and evidence synthesis

Implementing Regulation Policy in Brazilian Health Care Regulation Centers

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