Pediatric ambulatory appointment scheduling: a qualitative study of stakeholders’ perceptions and experiences

Quintanilha, Maira; Tink, Lisa N.; Perez, Arnaldo; O’Neill, Marcus G.; Holt, Nicholas L.; Bruce, Aisha; Childs, Michelle; Poitras, Sarah Kane; Kherani, Tamizan; Ladha, Tehseen; Majaesic, Carina; Webber, Melina; Ball, Geoff D.C.

doi:10.1093/intqhc/mzaa105

Cited by 3 publications

(3 citation statements)

References 35 publications

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“…In this analysis, it was clear that there were major di culties for asthma patients in accessing care including lack of a follow-up team, a lack of shared objectives between different levels of care, a lack of availability of specialist appointments in the public system, all of which limited access to specialized care and resulted in a failure to coordinate care in a timely manner, as described in previous studies of other health systems [28,29].…”

Section: Discussionmentioning

confidence: 77%

Integrated health care systems for asthma: A qualitative narrative study from the perspective of Ecuadorian health professionals

Granadillo

Romero-Sandoval

Cisneros-Caceres

et al. 2023

Preprint

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Background: Care coordination is a characteristic of integrated health service networks, understood as an action that, based on primary care, integrates the different levels of care. Care coordination can improve the quality of care, especially for chronic diseases such as asthma. Objective: To analyse perspectives of health professionals within different levels of care on the care coordination for asthma in Ecuador. Methods: Descriptive qualitative study. Guided by the Integrated Health Care Network Model, we completed 25 in-depth semi-structured interviews in three Ecuadorian cities between 2020 and 2021. Using purposive sampling, health care professionals were selected from primary, emergency, specialist, and managerial levels. We used narrative analysis to identify significant phrases from interviews. We followed the Standards for Reporting Qualitative Research. Results: Participants highlighted the scarce use of institutional documents for the referral of patients with asthma from the first level to specialists and vice versa, as well as between the different health subsystems. They identified weaknesses in the follow-up for patients with asthma, lack of objectives shared between the different levels of care, duplication of tests and medical prescriptions, and lack of availability of appointments in the public system that limits access to specialized care. The managers highlighted the system's inability to assign appointments on time and failures in administrative processes for follow-up. Emergency professionals do not have access to previous clinical data for patients having an asthma attack, so they rely on the use of emergency treatments without scheduling a specialist referral afterwards. Conclusions: From the perspectives of health professionals in Ecuador, asthma care coordination requires strengthening at all levels within the public health system, from the formulation of common goals to improved transfer of asthmatic patients between levels to optimize healthcare resources.

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Section: Discussionmentioning

confidence: 77%

Integrated health care systems for asthma: A qualitative narrative study from the perspective of Ecuadorian health professionals

Granadillo

Romero-Sandoval

Cisneros-Caceres

et al. 2023

Preprint

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“…Families, administrators, and clinicians may have different experiences in scheduling clinic appointments. Maira et al studied the views and experiences of scheduling pediatric outpatient appointments from the perspective of stakeholders [ 32 ]. Qualitative content analysis is used to analyze the three stakeholder groups.…”

Section: Discussionmentioning

confidence: 99%

Research on outpatient capacity planning combining lean thinking and integer linear programming

Yang

et al. 2023

BMC Med Inform Decis Mak

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Background The size and cost of outpatient capacity directly affect the operational efficiency of a whole hospital. Many scholars have faced the study of outpatient capacity planning from an operations management perspective. Objective The outpatient service is refined, and the quantity allocation problem of each type of outpatient service is modeled as an integer linear programming problem. Thus, doctors’ work efficiency can be improved, patients’ waiting time can be effectively reduced, and patients can be provided with more satisfactory medical services. Methods Outpatient service is divided into examination and diagnosis service according to lean thinking. CPLEX is used to solve the integer linear programming problem of outpatient service allocation, and the maximum working time is minimized by constraint solution. Results A variety of values are taken for the relevant parameters of the outpatient service, using CPLEX to obtain the minimum and maximum working time corresponding to each situation. Compared with no refinement stratification, the work efficiency of senior doctors has increased by an average of 25%. In comparison, the patient flow of associate senior doctors has increased by an average of 50%. Conclusion In this paper, the method of outpatient capacity planning improves the work efficiency of senior doctors and provides outpatient services for more patients in need; At the same time, it indirectly reduces the waiting time of patients receiving outpatient services from senior doctors. And the patient flow of the associate senior doctors is improved, which helps to improve doctors’ technical level and solve the problem of shortage of medical resources.

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“…Philosophically, our study was informed by the pragmatic approach as we focused on the problem being studied and were not committed to a specific philosophical or theoretical approach (Tashakkori & Teddlie, 2003). Previously, we published an article that explored stakeholders' perceptions and experiences related to appointment scheduling services (Quintanilha et al, 2020), which serves as a companion to the current report on stakeholders' recommendations.…”

Section: Methodsmentioning

confidence: 99%

Recommendations from parents, administrative staff and clinicians to improve paediatric ambulatory appointment scheduling

Kallos

Perez

O’Neill

et al. 2021

Child

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Background Stakeholders can provide valuable input to improve scheduling paediatric ambulatory clinic appointments, a complex process that requires effective planning and communication between parents, administrative staff and clinicians. The purpose of our study was to characterize recommendations from parents, administrative staff and clinicians to improve paediatric ambulatory appointment scheduling. Methods Conducted between February 2018 and January 2019, this qualitative study was guided by qualitative description. Data collection was completed using focus groups with three stakeholder groups: parents, administrative staff and clinicians. Participants provided recommendations to optimize paediatric ambulatory appointment scheduling at the Stollery Children's Hospital in Edmonton, Alberta, Canada. Focus group data were transcribed verbatim and analysed using manifest inductive content analysis. Results Forty‐six participants (mean age: 42.7; 87% female) participated in 12 focus groups. Parents (n = 11), administrative staff (n = 22) and clinicians (n = 13) made recommendations that were organized into two categories: appointment triaging and arranging. Triaging recommendations were related to appointment availability (e.g. providing alternatives to cancelling clinics with short notice) and waitlist management (e.g. developing clear and consistent policies regarding information flow and communication between clinics and administrative staff). Appointment arranging recommendations referred to booking (e.g. directly involving parents in the booking process), reminders (e.g. using text message reminders) and attendance (e.g. providing parents with a single point of contact who can provide the correct information about late and cancellation policies). Recommendations were similar across stakeholder groups. Conclusion Our findings showed congruent recommendations across stakeholder groups to address challenges with scheduling ambulatory appointments, many of which have the potential to be modified. Experimental research and quality improvement initiatives are needed to determine the feasibility, acceptability and effectiveness of stakeholder recommendations to improve triaging and scheduling paediatric ambulatory appointments.

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Pediatric ambulatory appointment scheduling: a qualitative study of stakeholders’ perceptions and experiences

Cited by 3 publications

References 35 publications

Integrated health care systems for asthma: A qualitative narrative study from the perspective of Ecuadorian health professionals

Integrated health care systems for asthma: A qualitative narrative study from the perspective of Ecuadorian health professionals

Research on outpatient capacity planning combining lean thinking and integer linear programming

Recommendations from parents, administrative staff and clinicians to improve paediatric ambulatory appointment scheduling

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