Related Experiment Videos
Healthcare Workflow Interventions to Reduce Delays in Urological Care: A Systematic Review
Rafaela Rosalba de Mendonça1, Marcello Perez Marques de Azevedo2, Maria Claudia Bicudo3
1Coordinator, Female Voiding Dysfunction and Urodynamic Unit - Instituto Prevent Senior; Urologist, Department of Urology, São Paulo, Brazil.
Background:
Delays in urological care can increase symptom burden, defer diagnosis and treatment, and reduce the efficiency of outpatient and surgical pathways. This review evaluated organisational interventions intended to improve patient flow and timely access to urological care.
Methods:
PubMed/MEDLINE, Cochrane CENTRAL, Web of Science, and Lens.org were searched for English-language studies published from 1 January 2020 to 25 July 2026. Two reviewers independently screened records and appraised methodological and reporting quality. Because interventions, designs, and outcomes were heterogeneous, findings were synthesized narratively. Reference-list (citation) searching identified additional eligible primary studies. The four-source search was rerun on 25 July 2026 and all retrieved records were re-screened against the prespecified eligibility criteria.
Results:
Twenty studies met the intervention eligibility criteria and were included in the synthesis; two further studies reporting patient experience without an implemented intervention are summarised separately as contextual evidence. Interventions were grouped into six domains: workforce redesign, fast-track pathways and service redesign, digital health and monitoring, surgical scheduling optimisation, waiting-list management, and system-level prioritisation. The largest reported improvements followed pathway redesign and active list management, including a decrease in urgent-referral waiting time from 59.0 to 21.6 days and a 76% reduction in patients waiting at least 12 months. Methodological and reporting quality scores ranged from 24 to 35 of 39 (mean 29.0); individual ratings and methodological concerns are provided in the supplementary material. Patient experience and long-term sustainability were infrequently measured. Several included studies were pandemic-specific, limiting direct generalisation to routine delivery.
Conclusion:
Workflow interventions can reduce delays in urological care, particularly when they combine explicit triage rules, protected capacity, workforce redesign, and active queue management. However, heterogeneous designs, limited patient-reported outcomes, and short follow-up reduce certainty about comparative effectiveness and sustainability.PROSPERO registration: CRD420261377822.