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Behind the clock: elucidating factors contributing to longer clinic appointment duration and patient wait time.
时钟后: 阐明有助于延长门诊预约时间和患者等待时间的因素。
- 影响因子:0
- DOI:10.1186/s12913-021-06079-y
- 作者列表:"Kagedan DJ","Edge SB","Takabe K
- 发表时间:2021-01-26
Abstract
BACKGROUND:Longer wait time in ambulatory clinics can disrupt schedules and decrease satisfaction. We investigated factors associated with patient wait time (WT, check-in to examination room placement), approximate clinician time (ACT, completion of nurse assessment to check-out), and total appointment length (TAL, check-in to check-out). METHODS:A single-institution retrospective study was conducted of breast surgery clinic patients, 2017-2019, using actual encounter times. A before/after analysis compared a five-day 8 hour/day (from a four-day 10 hour/day) advanced practice provider (APP) work-week. Non-parametric tests were used, and medians with interquartile ranges (IQRs) reported. RESULTS:15,265 encounters were identified. Overall WT was 15.0 minutes (IQR:6.0-32.0), ACT 49.0 minutes (IQR:31.0-79.0) and TAL 84.0 minutes (IQR:57.0-124.0). Trainees were associated with 30.0 minutes longer ACT (p < 0.0001); this increased time was greatest for follow-up appointments, least for new patients. Patients arriving > 5 minutes late (versus on-time) experienced shorter WT (11.0 vs. 15.0 minutes, p < 0.0001) and ACT (43.0 vs. 53.0 minutes, p < 0.0001). Busier days (higher encounter volume:APP ratios) demonstrated increased encounter times. After transitioning to a five-day APP work-week, ACT decreased. CONCLUSIONS:High-volume clinics and trainee involvement prolong ambulatory encounters. Increasing APP assistance, altering work schedules, and assigning follow-up appointments to non-trainees may decrease encounter time.
摘要
背景: 门诊中较长的等待时间可能会扰乱日程安排并降低满意度。我们调查了与患者等待时间 (WT,入住到检查室安置) 、近似临床医生时间 (ACT,完成护士评估到退房) 和总预约时间 (TAL,入住到退房) 相关的因素。 方法: 采用单机构回顾性研究乳腺外科门诊患者,2017-2019,使用实际遭遇次数。A之前/之后分析比较了五天8小时/天 (来自四天10小时/天) 高级实践提供商 (APP) 工作周。使用非参数检验,并报告了具有四分位距 (IQRs) 的中位数。 结果: 确定了15,265次遭遇。总体WT为15.0分钟 (IQR:6.0-32.0) 、ACT 49.0分钟 (IQR:31.0-79.0) 和TAL 84.0分钟 (IQR:57.0-124.0)。受训者与30.0分钟更长的ACT相关 (p <0.0001); 这种增加的时间对于随访预约是最大的,对于新患者是最少的。患者晚5分钟 (与准时相比) 出现较短的WT (11.0对15.0分钟,p <0.0001) 和ACT (43.0对53.0分钟,p <0.0001)。忙碌的日子 (更高的遭遇量: APP比率) 表明遭遇时间增加。在过渡到为期五天的应用程序工作周后,ACT下降了。 结论: 高容量诊所和受训者参与延长了门诊接触。增加应用程序帮助、改变工作时间表以及向非受训者分配后续约会可能会减少遭遇时间。
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