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From blacklist to beacon, a case study in reducing dermatology out-patient waiting times
1Department of Dermatology, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
Insights
Implementing internal initiatives significantly reduced dermatology waiting lists, improving patient access and service viability. Collaboration among healthcare professionals and management was key to success.
Area of Science:
- Dermatology
- Healthcare Management
- Public Health
Background:
- Dermatology departments face challenges with long waiting lists, impacting contract income and service provision.
- Severe waiting times (57 weeks) led to service fragmentation and potential loss of inpatient services.
- A national waiting list Beacon award recognized successful intervention efforts.
Purpose of the Study:
- To describe methods for increasing new patient throughput in dermatology.
- To outline strategies for reducing patient demand and appointment waiting times.
- To analyze the factors contributing to successful waiting list reduction.
Main Methods:
- Internally planned and driven initiatives were implemented.
- Collaboration involved medical staff, nursing staff, general practitioners, managers, and health authorities.
- Leadership by a dedicated consultant and effective management were crucial.
Main Results:
- Significant reduction in waiting times for new patient appointments was achieved.
- Increased new patient throughput and reduced overall demand were observed.
- The service was retrieved from fragmentation and potential ward closure.
Conclusions:
- Successful waiting list reduction requires multi-disciplinary involvement and strong leadership.
- Increasing demand necessitates demand management strategies, such as referral exclusion criteria, in resource-limited systems.
- Balancing healthcare supply and demand is essential for sustainable service provision.
Abstract:
At its worst our dermatology department had a waiting list for routine appointments of 57 weeks. As a result we started to lose contract income and consequently were unable to replace a retiring consultant. The service faced fragmentation and loss of the inpatient ward. Using a series of internally planned and driven initiatives it was possible to retrieve the situation. Our efforts were recognized by a national waiting list Beacon award in 1999. This study describes the methods used to increase new patient throughput, reduce demand and hence reduce waiting time for new patient appointments. Change was achieved only when medical, nursing staff, general practitioners, managers and health authorities were involved in the process. The changes needed to be led by a consultant enthusiast and managed effectively. There remains a constantly increasing demand for the service and reducing the waiting list simply invites a further increase in referral. In a resource-limited health care system the provider must be able to limit demand by using agreed referral exclusion criteria in order to balance supply and demand.
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