Staff perspectives of a model of access and triage for reducing waiting time in ambulatory services: a qualitative study

Harding, Katherine E, Snowdon, David A, Lewis, Annie K, Leggat, Sandra G, Kent, Bridie, Watts, Jennifer J and Taylor, Nicholas F 2019, Staff perspectives of a model of access and triage for reducing waiting time in ambulatory services: a qualitative study, BMC health services research, vol. 19, pp. 1-9, doi: 10.1186/s12913-019-4123-0.

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Title Staff perspectives of a model of access and triage for reducing waiting time in ambulatory services: a qualitative study
Author(s) Harding, Katherine E
Snowdon, David A
Lewis, Annie K
Leggat, Sandra G
Kent, Bridie
Watts, Jennifer JORCID iD for Watts, Jennifer J orcid.org/0000-0001-8095-8638
Taylor, Nicholas F
Journal name BMC health services research
Volume number 19
Article ID 283
Start page 1
End page 9
Total pages 9
Publisher BioMed Central
Place of publication London, Eng.
Publication date 2019-05-03
ISSN 1472-6963
Keyword(s) Access
Appointments and schedules
Clinician experience
Community health
Outpatients
Qualitative
Waiting lists
Summary Background
Specific Timely Appointments for Triage (STAT) is an intervention designed to reduce waiting time in community outpatient health services, shown to be effective in a large stepped wedge cluster randomised controlled trial. STAT combines initial strategies to reduce existing wait lists with creation of a specific number of protected appointments for new patients based on demand. It offers an alternative to the more traditional methods of demand management for these services using waiting lists with triage systems. This study aimed to explore perceptions of clinicians and administrative staff involved in implementing the model.

Method
Semi-structured interviews with 20 staff members who experienced the change to STAT were conducted by an independent interviewer. All eight sites involved in the original trial and all professional disciplines were represented in the sample. Data were coded and analysed thematically.

Results
Participants agreed that shorter waiting time for patients was the main advantage of the STAT model, and that ongoing management of caseloads was challenging. However, there was variation in the overall weight placed on these factors, and therefore the participants’ preference for the new or previous model of care. Perceptions of whether the advantages outweighed the disadvantages were influenced by five sub-themes: staff perception of how much waiting matters to the patient, prior exposure to the management of waiting list, caseload complexity, approach and attitude to the implementation of STAT and organisational factors.

Conclusions
The STAT model has clear benefits but also presents challenges for staff members. The findings of this study suggest that careful preparation and management of change and active planning for known fluctuations in supply and demand are likely to help to mitigate sources of stress and improve the likelihood of successful implementation of the STAT model for improving waiting times for patients referred to community outpatient services.
Language eng
DOI 10.1186/s12913-019-4123-0
Field of Research 1117 Public Health and Health Services
0807 Library and Information Studies
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2019, The Author(s)
Persistent URL http://hdl.handle.net/10536/DRO/DU:30121710

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