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Assessment of scheduling for patients referred for an abnormal red reflex
Joseph F Griffith1, Mingwei Sun2
1Department of Ophthalmology, Boston Children's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
Insights
The median scheduling lag time for urgent pediatric eye referrals was 1.8 days. Shorter lag times correlated with completed appointments, suggesting this metric can improve pediatric ophthalmology care.
Area of Science:
- Ophthalmology
- Pediatrics
- Healthcare Management
Background:
- Pediatric eye conditions like abnormal red reflex, cataract, leukocoria, and retinoblastoma require timely diagnosis and treatment.
- Scheduling lag time, defined as the interval between appointment scheduling and creation, can impact patient outcomes.
- Understanding this lag is crucial for optimizing care pathways in pediatric ophthalmology.
Purpose of the Study:
- To determine the scheduling lag time for urgent referrals in children under 8 years old.
- To analyze the relationship between scheduling lag time and appointment completion rates.
- To evaluate scheduling lag time as a potential quality improvement metric.
Main Methods:
- Retrospective chart review of 106 pediatric patients referred for specific eye conditions.
- Calculation of median scheduling lag time in days.
- Comparison of lag times for completed versus canceled appointments.
Main Results:
- The median scheduling lag time was 1.8 days (IQR, 0.8-5.0).
- 84% of appointments were completed as scheduled; 11% were canceled, 5% were no-shows.
- Completed visits had significantly shorter lag times (median, 1.1 days) than canceled visits (median, 12.0 days; P < 0.001).
Conclusions:
- Scheduling lag time is a measurable factor in pediatric ophthalmology referrals.
- Shorter scheduling lag times are associated with higher appointment completion rates.
- Monitoring scheduling lag time can serve as a quality improvement indicator for urgent pediatric eye care.
Abstract:
Scheduling lag time is the time between the date of an appointment and the date an appointment was created in the scheduling system. We sought to determine the scheduling lag time in a pediatric ophthalmology clinic for children <8 years of age, referred by a primary care provider for an abnormal red reflex (ARR), cataract, leukocoria, or retinoblastoma. The median scheduling lag time was 1.8 days (IQR, 0.8-5.0). Of the 106 total appointments, 89 (84%) were completed as scheduled, 12 (11%) were canceled, and 5 (5%) were no-shows. Ten patients (12%) were never seen. There was a shorter scheduling lag time for completed visits (median, 1.1 days; IQR, 0.2-4.0) than canceled visits (median, 12.0 days; IQR, 3.1-48.5; P < 0.001). Monitoring of the scheduling lag time for urgent referrals may be a metric for quality improvement in pediatric ophthalmology.
