Faculty of Health Sciences, La Trobe University, Melbourne, Australia; Allied Health Research Office, Eastern Health, Melbourne, Australia.
Arch Phys Med Rehabil. 2013 Jan;94(1):23-31. doi: 10.1016/j.apmr.2012.08.207. Epub 2012 Aug 25.
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.
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.
Two musculoskeletal CRP teams within a large metropolitan health service.
All patients referred to both sites during periods preintervention (n=483) and postintervention (n=488).
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.
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.
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.
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.
研究使用特定及时预约分诊（STAT）替代更为常见的分诊系统等待名单管理需求的方法，是否可以在不影响患者护理的情况下减少社区康复项目（CRP）的等待时间。
前瞻性、对照前后试验。在连续 2 年内，在 6 个月内收集干预前和干预后的数据。在干预点引入 STAT，并与使用分诊等待名单的对照点进行比较。
在一个大型大都市卫生服务机构内的两个肌肉骨骼 CRP 团队。
在干预前（n=483）和干预后（n=488）期间，所有被转诊至两个地点的患者。
根据平均转诊人数，临床医生每周制定特定数量的评估时间，患者在转诊时立即安排预约。
主要结果是从转诊到首次预约的时间；次要结果包括项目持续时间、生活质量评分（使用 EuroQol EQ-5D）和非计划性住院。
干预点的等待时间从平均 17.5 天减少到 10.0 天（P<.01），而对照点没有显著变化。干预点患者在 7 天内就诊的可能性是对照点患者的 3 倍以上（优势比，3.3；95%置信区间，2.2-4.9）。两组间的次要结果无显著差异。
使用特定及时预约分诊替代分诊等待名单来管理 CRP 转诊可以减少等待时间，而不会对护理产生不利影响。结果在 6 个月内持续存在，且无需额外资源。
