scholarly journals An Audit of Wait Times for Service Offered by the Gynaecology Oncology Unit at the University Hospital in Jamaica: Are We Meeting the Standards?

2016 ◽  
Vol 2 (3_suppl) ◽  
pp. 74s-74s
Author(s):  
Ian Bambury ◽  
Christopher Fletcher ◽  
Carole Rattray ◽  
Matthew Taylor ◽  
Charmaine Mitchell ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Conflicts Of Interest ◽  
Waiting Times ◽  
Wait Time ◽  
International Standards ◽  
University Hospital ◽  
Wait Times ◽  
Oncology Unit ◽  
The University ◽  
Mean Time

Abstract 53 Background: The European Board and College of Obstetrics and Gynaecology recommends that time from referral of suspected or proven gynaecological cancers to consultation should be within two weeks and that initiation of treatment should occur within six weeks. It is has been shown that a delay in waiting times beyond these international standards results in significantly increased morbidity and mortality. Methods: An audit of wait times was performed for all patients who presented to the gynaecology oncology unit at the University Hospital in Jamaica for consultation between January 1, 2013 and December 31, 2013. Wait time for consultation was calculated as the date of first referral to the date of initial consultation. Wait time for treatment was calculated as time from consultation to either surgery or initiation of radiation therapy or chemotherapy. Primary site, stage, and the region from which the referrals came were abstracted from the medical record. Results: A total of 1,289 unique patients were seen at least once during the audit period; of these, 108 were new consultations and 1,219 were patients seen for follow-up. 72% were from the greater metropolitan area (Kingston & St. Andrew), while the others were from the surrounding parishes of Jamaica. Of the 108 new patients, malignancy was confirmed in 70 (65%). Case make-up included 23 cases of endometrial cancer (33%); 20 cases of cervical cancer (29%); 16 cases of ovarian cancer (23%); and 11 cases of other gynecologic cancers (vulvar, vaginal, choriocarcinoma) (15%). At presentation, there were 23 patients with stage 1 disease (33%), 16 patients with stage 2 disease (23%), 27 patients with stage 3 disease (38%); and 4 patients with stage 4 disease (6%). 39 out of 70 patients with malignancy (56%) underwent surgery; 11 (15.7%) were treated with radiation therapy; and 22 (31%) were treated with chemotherapy. Among patients with a cancer diagnosis, the mean time from referral to consultation was 2.1 weeks. Mean time from consultation to surgery was 7.6 weeks; mean time from consultation to start of radiotherapy was 16 weeks; and mean time from consultation to start of chemotherapy was 11.6 weeks. 66% of patients underwent surgery within the international standard of six weeks from referral. Only 36% initiated radiation therapy and 14% initiated chemotherapy within six weeks from referral. Conclusion: While the majority of patients met international standards for time to consultation to surgery, wait times for initiation of radiation and chemotherapy were sub-standard. This audit has provided information that will help us to assess the inadequacy of available services and could potentially inform national cancer policies in Jamaica. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST: No COIs from the authors.

scholarly journals Online Ratings of Primary Care Physicians: Comparison of Gender, Training, and Specialty

2021 ◽  
Vol 8 ◽  
pp. 237437352110077
Author(s):  
Daliah Wachs ◽  
Victoria Lorah ◽  
Allison Boynton ◽  
Amanda Hertzler ◽  
Brandon Nichols ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Waiting Times ◽  
Wait Time ◽  
Primary Care Providers ◽  
Wait Times ◽  
Care Providers ◽  
Female Physicians ◽  
Online Ratings ◽  
And Gender

The purpose of this study was to explore patient perceptions of primary care providers and their offices relative to their physician’s philosophy (medical degree [MD] vs doctorate in osteopathic medicine [DO]), specialty (internal medicine vs family medicine), US region, and gender (male vs female). Using the Healthgrades website, the average satisfaction rating for the physician, office parameters, and wait time were collected and analyzed for 1267 physicians. We found female doctors tended to have lower ratings in the Midwest, and staff friendliness of female physicians were rated lower in the northwest. In the northeast, male and female MDs were rated more highly than DOs. Wait times varied regionally, with northeast and northwest regions having the shortest wait times. Overall satisfaction was generally high for most physicians. Regional differences in perception of a physician based on gender or degree may have roots in local culture, including proximity to a DO school, comfort with female physicians, and expectations for waiting times.

Spectrum of conjunctival tumours in a Spanish series: A review of 462 cases

2019 ◽  
Vol 30 (6) ◽  
pp. 1403-1409
Author(s):  
Luis García Onrubia ◽  
Gabriela Estefanía Pacheco-Callirgos ◽  
Alejandro Portero-Benito ◽  
Ciro García-Álvarez ◽  
Ester Carreño Salas ◽  
...  
Keyword(s):  
Precancerous Lesions ◽  
Case Series ◽  
University Hospital ◽  
Malignant Tumours ◽  
Benign Lesions ◽  
Routine Examination ◽  
Retrospective Case ◽  
Main Complaint ◽  
Oncology Unit ◽  
The University

Introduction: To report the spectrum and frequency of conjunctiva tumours in an ocular oncology unit analysing the clinical profile of benign, precancerous and malignant conjunctival lesions. Methods: A retrospective case series of 462 consecutive patients diagnosed at the Ocular Oncology Unit of the University Hospital of Valladolid from 1992 to 2017. Results: Among 462 consecutive patients, the tumour was classified as melanocytic in 252 (54.5%) and non-melanocytic in 210 (45.5). Two hundred forty-eight males (mean age 51.63 (SD = 23.20)) and 214 females (mean age 48.27 (SD = 21.77)) were included. Mean patient age at diagnosis was 50.07 years (range = 1-92 years). The majority of tumours were benign (n = 307 (66.5%)) followed by precancerous (n = 103 (22.3%)) and finally by malignant ones (n = 52 (11.3%)). Benign lesions were predominantly found in younger individuals rather than premalignant (p < 0.05) and malignant ones (p < 0.05). Most of the melanocytic lesions were benign (88.5%), most epithelial ones were precancerous (61.4%) and most lymphoid lesions were malignant (56.3%). Tumours involving one or four quadrants of the ocular surface usually were benign, unlike tumours involving three quadrants that were malignant (16 (48.5%) p < 0.05). The majority of benign lesions were detected on females (n = 163 (53.1%)) by routine examination (n = 178 (86.4%)). However, main complaint in malignant tumours was the growth of the lesion (n = 39 (76.5%)). Conclusion: Most of the conjunctival tumours were melanocytic, mostly benign, closely followed by those of epithelial origin, with a predominance of precancerous lesions. Melanocytic, epithelial and lymphoid tumours accounted for over 90% of cases. A trend was identified with benign lesions being found in younger female patients on routine examination.

scholarly journals Dietitian first gastroenterology clinic: an initiative to reduce wait lists and wait times for gastroenterology outpatients in a tertiary hospital service

2018 ◽  
Vol 10 (3) ◽  
pp. 229-235 ◽  
Author(s):  
Rumbidzai N Mutsekwa ◽  
Russell Canavan ◽  
Anthony Whitfield ◽  
Alan Spencer ◽  
Rebecca L Angus
Keyword(s):  
Patient Flow ◽  
Wait Time ◽  
Tertiary Hospital ◽  
University Hospital ◽  
Wait Times ◽  
Activity Data ◽  
Patient Journey ◽  
Service Activity ◽  
High Level ◽  
The Impact

ObjectiveThe demand for outpatient gastroenterology medical specialist consultations is above what can be met within budgetary and staffing constraints. This study describes the establishment of a dietitian first gastroenterology clinic to address this issue, the patient journey and its impact on wait lists and wait times in a tertiary gastroenterology service.DesignA dietitian first gastroenterology clinic model was developed and a mixed-methods approach used to evaluate the impact of the service over a 21-month period.SettingGold Coast University Hospital, Queensland, Australia (a public tertiary hospital).Patients658 patients were triaged to the clinic between June 2016 and March 2018.InterventionA dietitian first gastroenterology clinic for low-risk gastroenterology patients.Main outcome measuresWe examined demographic, referral, wait list, wait time and service activity data, patient satisfaction and patient journey.ResultsAt the time of audit, 399 new (67.9% female) and 307 review patients had been seen. Wait times for eligible patients reduced from 280 to 66 days and the percentage of those in breach of their recommended wait times reduced from 95% to zero. The average time from referral to discharge was 117.8 days with an average of 2.4 occasions of service. 277 patients (69.4%) had been discharged to the care of their general practitioner and 43 patients (10.7%) had an expedited specialist medical review. Patient surveys indicated a high level of satisfaction.ConclusionA dietitian first gastroenterology model of care helps improve patient flow, reduces wait times and may be useful elsewhere to address outpatient gastroenterology service pressures.

scholarly journals Waiting for Treatment for Chronic Pain – a Survey of Existing Benchmarks: Toward Establishing Evidence-Based Benchmarks for Medically Acceptable Waiting Times

2007 ◽  
Vol 12 (4) ◽  
pp. 245-248 ◽  
Author(s):  
Mary E Lynch ◽  
Fiona A Campbell ◽  
Alexander J Clark ◽  
Michael J Dunbar ◽  
David Goldstein ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Pain ◽  
Time Management ◽  
Task Force ◽  
International Association ◽  
Waiting Times ◽  
Wait Time ◽  
Wait Times ◽  
Pain Clinics ◽  
The World

As medical costs escalate, health care resources must be prioritized. In this context, there is an increasing need for benchmarks and best practices in wait time management. In December 2005, the Canadian Pain Society struck a Task Force to identify benchmarks for acceptable wait times for treatment of chronic pain. The task force mandate included a systematic review and survey to identify national or international wait time benchmarks for chronic pain, proposed or in use, along with a review of the evidence upon which they are based. An extensive systematic review of the literature and a survey of International Association for the Study of Pain Chapter Presidents and key informants has identified that there are no established benchmarks or guidelines for acceptable wait times for the treatment of chronic pain in use in the world. In countries with generic guidelines or wait time standards that apply to all outpatient clinics, there have been significant challenges faced by pain clinics in meeting the established targets. Important next steps are to ensure appropriate additional research and the establishment of international benchmarks or guidelines for acceptable wait times for the treatment of chronic pain. This will facilitate advocacy for improved access to appropriate care for people suffering from chronic pain around the world.

Minimizing wait time between chemotherapy and radiotherapy treatments.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 82-82
Author(s):  
James J. Sauerbaum ◽  
Gina DeMaio ◽  
Bradley Geiger ◽  
Regina Cunningham ◽  
Marianna Holmes ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Task Force ◽  
Wait Time ◽  
Support Staff ◽  
Cancer Center ◽  
Wait Times ◽  
Average Wait Time ◽  
Scheduling Method ◽  
Reduce Wait Time ◽  
E Mail

82 Background: Members of the scheduling teams at the Abramson Cancer Center observed prolonged delays between chemotherapy and radiation therapy treatments scheduled by staff from 2 independent departments leading to inconvenience for patients receiving concurrent chemo- and radiation therapy (CRpts). Methods: An analysis of baseline data over 6 weeks revealed that for 157 unique consecutive patients undergoing daily chemotherapy and radiation (a total of 353 encounters), the mean time between scheduled treatments was 122 minutes. For 39% of encounters the wait time was greater than 120 minutes. To improve the adjacency of chemotherapy and radiation appointments and to consistently reduce wait time between treatments to less than 120 minutes, we formed a Chemotherapy/Radiation Scheduling Task Force consisting of patient service representatives, practice managers, and physician and nurse advisors. We determined that CRpts should be scheduled using a “huddle” strategy whereby prospectively identified CRpts are simultaneously scheduled for both treatments in a coordinated manner. Identifying CRpts for coordinated scheduling was facilitated by the creation of a chemo-radiation scheduling inbox to which clinicians and support staff e-mail names of new CRpts in order to alert the scheduling team. Our two lead schedulers meet 2-3 times per week to coordinate patient schedules. A weekly scorecard of the wait times for CRpts patients is distributed via e-mail to the clinicians and support staff. Results: Over the past 6 months, we have used the huddle method for 80% of 986 consecutive CRpt encounters. Our average wait time for huddle-scheduled encounters has been reduced to 62.5 minutes with only 9% of encounters having wait times over 120 minutes. For non-huddle-scheduled encounters, the average wait time is 129 minutes with 57% having wait times over 120 minutes. Conclusions: Utilization of a huddle scheduling method has successfully reduced wait time for CRpts. Use of the huddle method continues to grow with staff training and awareness of the new process.

scholarly journals P.017 Results of a Pilot feasibility study to develop reduce wait times strategy in the evaluation of children with new onset epilepsy

2018 ◽  
Vol 45 (s2) ◽  
pp. S20-S20
Author(s):  
JA Mailo ◽  
M Diebold ◽  
E Mazza ◽  
P Guertjens ◽  
H Gangam ◽  
...  
Keyword(s):  
Patient Flow ◽  
Waiting Times ◽  
Wait Time ◽  
Febrile Seizures ◽  
Limiting Factors ◽  
Wait Times ◽  
Timely Access ◽  
Flow Through ◽  
Pilot Feasibility Study ◽  
New Onset

Background: The goal was to understand factors leading to prolonged wait times for neurological assessment of children with new onset seizures. A second objective was to develop an innovative approach to patient flow through and achieve a reduction in waiting times utilizing limited resources.Methods:Audit of the referrals, flow through, wait timesIdentification of bottlenecksDevelopment of triaging strategy:Suspected Febrile seizures and non-epileptic events;Suspected benign and absence epilepsies;Suspected other Focal epilepsies, generalized epilepsies, epilepsy under 2 yearsInitiation of early telephone contact and supportDevelopment of a ketogenic dietResults: Using a triaging strategy and focusing on timely access to investigations, wait times for clinic evaluations were shortened despite larger numbers of referrals (mean wait time reductions from 179 to 91 days). Limiting factors such increase in referral numbers, attrition in support staff, interfered with sustainability of reduced wait times achieved in the initial phase of the program. Conclusions: This pilot study highlights the effectiveness of an innovative triaging strategy and improvements in patient flow through in achieving the goals of reduction in wait times for clinical evaluation and timely investigations to improve care for children with new onset seizures. Insights into limitations of such strategies and factors determining sustainability are discussed.

Formative Exploration of the Relationship Between Waiting Times and Attendance at General Adult Psychiatry Clinics, at a Hospital in Pennine Care NHS Foundation Trust

2017 ◽  
Vol 41 (S1) ◽  
pp. S607-S607
Author(s):  
M. Gan ◽  
S. Salujha
Keyword(s):  
Waiting Times ◽  
Wait Time ◽  
Wait Times ◽  
Clinic Attendance ◽  
Outpatient Psychiatry ◽  
Adult Psychiatry ◽  
Adult Outpatient ◽  
Competing Interest ◽  
The Relationship ◽  
Patient Referrals

IntroductionAn audit was done to assess new patient wait times. As part of this project we reviewed possible relationships between wait times and clinic attendance.ObjectiveTo examine available data, for possible explanations of patients’ attendance behaviour at outpatient clinics.AimsTo identify possible correlation between length of waiting time for adult psychiatry appointments and status of attendance.MethodService Line: New patient referrals to adult outpatient psychiatry (January–December 2015)Sample size: 401.ResultsFig. 1 and Table 1 show wait times compared with clinic attendance outcome. Percentage attendance appeared to gradually fall as wait times increased; while cancellation (%) by the NHS, and DNAs (did not attend) by the patient, appeared to rise over time.ConclusionsThis review has demonstrated a possible correlation between wait time for a clinic appointment and how patients behave. The shorter a patient has to wait; it appears they are more likely to actually attend clinic. If so, this potentially has implications for discussions around possible reorganization of services, to improve engagement and outcomes, by coming up with innovative ways of reducing wait times.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Use of LOINC and SNOMED CT with FHIR for Microbiology Data

2021 ◽  
Author(s):  
Eugenia Rinaldi ◽  
Julian Saas ◽  
Sylvia Thun
Keyword(s):  
Infection Control ◽  
Data Sharing ◽  
Information Exchange ◽  
International Standards ◽  
University Hospital ◽  
Use Case ◽  
Snomed Ct ◽  
University Hospitals ◽  
Related Data ◽  
The University

Infectious diseases due to microbial resistance pose a worldwide threat that calls for data sharing and the rapid reuse of medical data from health care to research. The integration of pathogen-related data from different hospitals can yield intelligent infection control systems that detect potentially dangerous germs as early as possible. Within the use case Infection Control of the German HiGHmed Project, eight university hospitals have agreed to share their data to enable analysis of various data sources. Data sharing among different hospitals requires interoperability standards that define the structure and the terminology of the information to be exchanged. This article presents the work performed at the University Hospital Charité and Berlin Institute of Health towards a standard model to exchange microbiology data. Fast Healthcare Interoperability Resources (FHIR) is a standard for fast information exchange that allows to model healthcare information, based on information packets called resources, which can be customized into so-called profiles to match use case- specific needs. We show how we created the specific profiles for microbiology data. The model was implemented using FHIR for the structure definition, and the international standards SNOMED CT and LOINC for the terminology services.

scholarly journals Predicting Patient Wait Times in the Phlebotomy Unit

2020 ◽  
pp. 1-5
Author(s):  
Dilek Orbatu ◽  
Oktay Yıldırım ◽  
Eminullah Yaşar ◽  
Ali Rıza Şişman ◽  
Süleyman Sevinç
Keyword(s):  
Waiting Time ◽  
Waiting Times ◽  
Wait Time ◽  
High Accuracy ◽  
Wait Times ◽  
Blood Collection ◽  
Time Prediction ◽  
Number Of Patients ◽  
Patient Will ◽  
Patient Waiting Time

Patients frequently complain of long waiting times in phlebotomy units. Patients try to predict how long they will stay in the phlebotomy unit according to the number of patients in front of them. If it is not known how fast the queue is progressing, it is not possible to predict how long a patient will wait. The number of prior patients who will come to the phlebotomy unit is another important factor that changes the waiting time prediction. We developed an artificial intelligence (AI)-based system that predicts patient waiting time in the phlebotomy unit. The system can predict the waiting time with high accuracy by considering all the variables that may affect the waiting time. In this study, the blood collection performance of phlebotomists, the duration of the phlebotomy in front of the patient, and the number of prior patients who could come to the phlebotomy unit was determined as the main parameters affecting the waiting time. For two months, actual wait times and predicted wait times were compared. The wait time for 95 percent of the patients was predicted with a variance of ± 2 minutes. An AI-based system helps patients make predictions with high accuracy, and patient satisfaction can be increased.

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