Harding Katherine E, Robertson Nicole, Snowdon David A, Watts Jennifer J, Karimi Leila, O'Reilly Mary, Kotis Michelle, Taylor Nicholas F
La Trobe University, Kingsbury Drive, Bundoora, Vic. 3086, Australia. Email:.
Eastern Health, 5 Arnold Street, Box Hill, Vic. 3128, Australia. Email: ;
Aust Health Rev. 2018 Feb;42(1):93-99. doi: 10.1071/AH16145.
Objectives Wait lists are common in ambulatory and community-based services. The aim of the present study was to explore managers' perceptions of factors that contribute to wait times. Methods A qualitative study was conducted using semi-structured interviews with managers and team leaders of ambulatory and community health services within a large health network. Interviews were transcribed and coded, and the codes were then grouped into themes and subthemes. Results Representatives from 26 services participated in the project. Four major themes were identified. Three themes related to reasons and factors contributing to increased wait time for services (inefficient intake and scheduling processes; service disruptions due to human resource issues; and high service demand). A fourth theme related to staff attitudes towards wait times and acceptance and acknowledgement of wait lists. Conclusions Service providers perceive high demand to be a key driver of wait times, but a range of other factors also contributes and may represent opportunities for improving access to care. These other factors include improving process efficiencies, greater consistency of service delivery through more efficient management of human resources and shifting to more consumer-centred approaches in measuring wait times in order to drive improvements in patient flow. What is known about the topic? Wait times are common in out-patient and ambulatory services. These services experience high demand, which is likely to continue to grow as health service delivery shifts from hospital to community settings. What does this paper add? Although demand is an important driver of wait times, there are other modifiable factors that also contribute, including process inefficiencies and service disruption related to human resource issues. An underlying staff attitude of acceptance of wait times appears to be an additional barrier to improving access. What are the implications for practitioners? The findings of the present study suggest that there are opportunities for improving access to ambulatory and community health services through more efficient use of existing resources. However, a more consumer-focused approach regarding acceptability of wait times is needed to help drive change.
目标 在门诊和社区服务中，等候名单很常见。本研究的目的是探讨管理人员对导致等候时间的因素的看法。方法 采用定性研究方法，对一个大型医疗网络中的门诊和社区卫生服务的管理人员和团队领导进行半结构化访谈。访谈内容被转录和编码，然后将代码分组为主题和子主题。结果 来自26个服务机构的代表参与了该项目。确定了四个主要主题。三个主题与导致服务等候时间增加的原因和因素有关（低效的接诊和排班流程；由于人力资源问题导致的服务中断；以及高服务需求）。第四个主题与工作人员对等候时间的态度以及对等候名单的接受和认可有关。结论 服务提供者认为高需求是等候时间的关键驱动因素，但一系列其他因素也有影响，并且可能代表了改善就医机会的契机。这些其他因素包括提高流程效率、通过更有效的人力资源管理实现更高的服务提供一致性，以及转向以消费者为中心的方法来衡量等候时间，以推动患者流程的改善。关于该主题已知的情况是什么？等候时间在门诊和流动服务中很常见。这些服务面临高需求，随着医疗服务提供从医院转向社区环境，这种需求可能会持续增长。本文补充了什么？虽然需求是等候时间的一个重要驱动因素，但还有其他可改变的因素也有影响，包括流程效率低下和与人力资源问题相关的服务中断。工作人员对等候时间的接受态度似乎是改善就医机会的另一个障碍。对从业者有什么启示？本研究的结果表明，通过更有效地利用现有资源，有机会改善门诊和社区卫生服务的就医机会。然而，需要一种更以消费者为中心的方法来对待等候时间的可接受性，以帮助推动变革。
