Vanderhout Shelley, Taneja Shipra, Hamour Amr, Monterio Eric, Chung Janet
Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada.
Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada.
J Otolaryngol Head Neck Surg. 2025 Jan-Dec;54:19160216251321456. doi: 10.1177/19160216251321456. Epub 2025 Mar 17.
BackgroundNew patient referral models are needed to reduce long wait times for otolaryngology surgical procedures, such as a Single-Entry Model (SEM). However, patient perspectives about SEM in otolaryngology remain unexplored.MethodsIn this mixed methods study, a retrospective chart review was conducted to examine the times from referral to consultation (T1) and from consent to surgery (T2) for all elective otolaryngology surgical procedures at a large community hospital between 2020 and 2023. We then conducted journey mapping interviews with 10 patients and parents of pediatric patients who underwent otolaryngologic surgeries to understand their experiences of waiting for their own or their child's procedure, and perspectives on how an SEM might impact patient experiences. Data were analyzed using descriptive statistics and thematic analysis.ResultsWe identified that average wait times among 2414 elective (oncologic and non-oncologic) otolaryngology procedures often exceeded provincial target wait times. On average, oncology procedures had the shortest wait times (T1: 34 ± 47; T2: 101 ± 161 days), and otologic procedures had the longest (T1: 67 + 72; T2: 355 ± 285 days). While patients often did not wait as long to have a consultation with their surgeon, the time between consenting to and receiving surgery tended to drive wait time duration. Patients who had endured extended wait times experienced poor quality of life, worsening symptoms, and often worried about how long they would need to wait. Systems such as an SEM that could shorten wait times were generally well-perceived. However, patients emphasized the importance of trusting relationships with referring physicians and surgeons, which could be an enabling factor for implementing an SEM.ConclusionLong surgical wait times in otolaryngology are negatively impacting patients. A SEM could offer a way to improve patient experiences and outcomes.
背景
需要新的患者转诊模式来减少耳鼻喉科手术的长时间等待，例如单入口模式（SEM）。然而，患者对耳鼻喉科SEM的看法仍未得到探索。
方法
在这项混合方法研究中，我们进行了一项回顾性病历审查，以检查2020年至2023年期间一家大型社区医院所有择期耳鼻喉科手术从转诊到会诊（T1）以及从同意手术到手术（T2）的时间。然后，我们对10名接受过耳鼻喉科手术的患者和儿科患者的家长进行了旅程映射访谈，以了解他们等待自己或孩子手术的经历，以及对SEM可能如何影响患者体验的看法。使用描述性统计和主题分析对数据进行了分析。
结果
我们发现，2414例择期（肿瘤和非肿瘤）耳鼻喉科手术的平均等待时间常常超过省级目标等待时间。平均而言，肿瘤手术的等待时间最短（T1：34±47；T2：101±161天），耳科手术的等待时间最长（T1：67 + 72；T2：355±285天）。虽然患者与外科医生会诊的等待时间通常没有那么长，但从同意手术到接受手术之间的时间往往决定了等待时间的长短。经历过长时间等待的患者生活质量较差，症状加重，并且常常担心自己还需要等待多久。像SEM这样可以缩短等待时间的系统总体上得到了良好的评价。然而，患者强调了与转诊医生和外科医生建立信任关系的重要性，这可能是实施SEM的一个促成因素。
结论
耳鼻喉科手术的长时间等待对患者产生了负面影响。SEM可以提供一种改善患者体验和结局的方法。
