Improving out-patient clinic waiting times: methodological and substantive issues.

In the Patients' Charter, a standard is laid down that all patients who attend out-patient clinics should be seen within 30 minutes of their appointment time. Discusses how a statistical monitoring system using a "low technology" approach was implemented at Leicester General Hospital during 1992-93. This was instrumental in raising the proportion of patients seen within 30 minutes from under 50 per cent to over 80 per cent in 15 months. Points to the fact that statistical monitoring alone is not sufficient to deliver quality improvements. Suggests that only enlightened management action which brings both management and clinicians into a quality improvement programme is likely to be effective. Discusses some of the measurement problems involved. Warns against the fact that over-reliance on purely quantitative measures (as indicated in "Charter" standards) to the neglect of more qualitative measures may be counterproductive. Suggests that qualitative approaches need to complement the normal statistical monitoring.