Reducing Outpatient Psychiatry Wait Times Through Structured Triage and Telephone Consultation: A Quality Improvement...

Prolonged wait times for outpatient psychiatric care are a persistent problem across health systems and have been exacerbated following the COVID-19 pandemic, particularly in community hospital settings with limited specialist capacity. Purpose. To describe and evaluate a psychiatrist-led telephone consultation triage pathway designed to optimize specialist time and reduce outpatient psychiatry wait times. A quality improvement initiative was implemented in November 2022 at a Canadian community hospital. A structured triage process was applied to all outpatient psychiatry referrals, with selected lower-complexity referrals redirected to alternative pathways or addressed through psychiatrist-led telephone consultations with primary care providers. Service-level metrics were examined descriptively. Between November 2022 and May 2023, 687 outpatient psychiatry referrals were reviewed. Of these, 495 (72%) were accepted for psychiatric assessment and 192 (28%) were redirected. Following implementation, psychiatrist-led telephone consultations increased from approximately one per month to 12-15 per month. Compared with standard 90-minute psychiatric assessments, telephone consultations averaged approximately 10 min. Average outpatient wait times decreased from approximately 10 months prior to implementation to approximately 6 weeks during the post-implementation period. A structured psychiatrist-led telephone consultation triage pathway was associated with improved access to outpatient psychiatric care in a community hospital setting. This pragmatic, low-cost approach may be relevant to other services facing similar post-pandemic pressures.