Article

OBJECTIVE: To investigate whether a simple alternative (specific timely
appointments for triage [STAT]) to the more common approach of managing demand
using a waitlist with a triage system could reduce waiting time for a community
rehabilitation program (CRP) without adverse impacts on patient care. DESIGN: A
prospective, controlled before-and-after trial. Preintervention and
postintervention data were collected for 6 months in 2 consecutive years. STAT
was introduced at an intervention site and compared with a control site using a
triaged waitlist. SETTING: Two musculoskeletal CRP teams within a large
metropolitan health service. PARTICIPANTS: All patients referred to both sites
during periods preintervention (n=483) and postintervention
(n=488).
INTERVENTION: Under STAT, clinicians created a specified number of assessment
times each week based on average referral numbers, and patients were immediately
allocated an appointment on referral. MAIN OUTCOME MEASURES: The primary outcome
was the time from referral to first appointment; secondary outcomes included
program duration, quality-of-life scores (using the EuroQol EQ-5D), and unplanned
hospital admissions. RESULTS: Waiting time decreased from a mean of 17.5 days to
10.0 days (P<.01) at the intervention site, with no significant change at the
control site. Intervention site patients were over 3 times more likely to be seen
within 7 days than control site patients (odds ratio, 3.3; 95% confidence
interval, 2.2-4.9). Secondary outcomes did not differ significantly between
groups. CONCLUSIONS: A simple alternative to using a triaged waitlist to manage
CRP referrals reduced waiting time without adversely affecting care. Results were
sustained over 6 months with no additional resources.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS