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Streamlining Health Care Access for Patients With Primary Hyperparathyroidism: A Quality Improvement Pilot Program
Nora O Sheu1, Stefanie J Soelling1, Jake A Awtry1
1Division of Surgical Oncology, Brigham and Women's Hospital, Boston, Massachusetts.
The Journal of Surgical Research
|July 15, 2025
Summary
Directly referring primary hyperparathyroidism (pHPT) patients to endocrine surgery significantly reduced wait times for appointments. This expedited care pathway streamlined access to surgical evaluation and treatment for pHPT.
Area of Science:
- Endocrinology
- Surgical Oncology
- Health Services Research
Background:
- Hyperparathyroidism (HPT) evaluation often involves lengthy endocrinology wait times.
- A pilot program aimed to improve access for primary HPT (pHPT) patients.
Purpose of the Study:
- To compare referral-to-appointment times for endocrine surgery versus endocrinology.
- To determine if direct triage to endocrine surgery expedites care for pHPT patients.
Main Methods:
- Patients with HPT were screened for pHPT criteria (Ca ≥10.7, PTH ≥65).
- Eligible patients were referred directly to endocrine surgery; others to endocrinology.
- Time to appointment, demographics, labs, and surgical outcomes were analyzed.
Main Results:
- Direct referral to endocrine surgery resulted in a mean appointment time of 28 days versus 118 days for endocrinology (P < 0.001).
- Endocrine surgery patients had higher calcium levels but similar parathyroid hormone levels.
- 78.7% of endocrine surgery patients underwent parathyroid surgery compared to 16.7% of endocrinology patients.
Conclusions:
- Initial referral to endocrine surgery significantly decreases evaluation time for pHPT patients.
- This pathway streamlines surgical access and reduces the burden on endocrinology services.
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