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首页> 外文OA文献 >The challenge of long waiting lists: how we implemented a GP referral system for non-urgent specialist' appointments at an Australian public hospital
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The challenge of long waiting lists: how we implemented a GP referral system for non-urgent specialist' appointments at an Australian public hospital

机译：等候名单长的挑战：我们如何为澳大利亚公立医院的非紧急专科医生任命实施GP转诊系统

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Our Problem\udThe length of wait lists to access specialist clinics in the public system is problematic for Queensland Health, general practitioners and patients. To address this issue at The Townsville Hospital, the GP Liaison Officer, GPs and hospital staff including specialists, collaborated to develop a process to review patients waiting longer than two years. GPs frequently send referrals to public hospital specialist clinics. Once received, referrals are triaged to Category A, B or C depending on clinical criteria resulting in appointment timeframes of 30, 90 or 365 days for each category, respectively. However, hospitals often fail to meet these targets, creating a long wait list. These wait listed patients are only likely to be seen if their condition deteriorates and an updated referral upgrades them to Category A.\ud\udProcess to Address the Problem\udA letter sent to long wait patients offered two options 1) take no action if the appointment was no longer required or 2) visit their GP to update their referral on a clinic specific template if they felt the referral was still required. Local GPs were advised of the trial and provided education on the new template and minimum data required for specialist referrals.\ud\udWhat Happened\udIn 2008, 872 letters were sent to long wait orthopaedic patients and 101 responded. All respondents were seen at specially arranged clinics. Of these, 16 patients required procedures and the others were discharged. In 2009 the process was conducted in the specialties of orthopaedics, ENT, neurosurgery, urology, and general surgery. Via this new process 6885 patients have been contacted, 633 patients have been seen by public hospital specialists at specially arranged clinics and 197 have required a procedure.\ud\udLearnings\udSince the start of this process in 2008, the wait time to access a specialist appointment has reduced from eight to two years. The process described here is achievable across a range of specialties, deliverable within the routine of the referral centre and identifies the small number of people on the long wait list in need of a procedure.
机译：我们的问题\ ud对昆士兰州卫生局，全科医生和患者而言，进入公共系统中的专科门诊的等待时间太长。为了在汤斯维尔医院解决此问题，全科医生联络官，全科医生和医院工作人员（包括专家）共同制定了流程，以审查等待时间超过两年的患者。全科医生经常将转诊信送到公立医院的专科诊所。收到转诊后，根据临床标准将转诊分为A，B或C类，导致每个类别的预约时间分别为30、90或365天。但是，医院常常无法达到这些目标，从而造成了漫长的等待名单。这些等待入院的患者只有在他们的病情恶化并且经过更新的转诊将其升级到A类后才能看到。\ ud \ ud解决问题的过程\ ud给长期等待患者的信提供了两种选择1）如果不再需要预约或2）如果他们认为仍然需要转诊，请访问其全科医生以诊所特定模板更新其转诊。建议当地的全科医生进行试验，并就新模板和专家推荐所需的最低数据提供教育。\ ud \ ud发生了什么\ ud2008年，向长期等待的骨科患者发送了872封信，有101封信得到了答复。所有受访者都被安排在专门安排的诊所。其中，有16名患者需要手术，其他患者已出院。 2009年，该过程在骨科，耳鼻喉科，神经外科，泌尿科和普通外科等专业进行。通过这一新程序，已经联系了6885名患者，公立医院的专家在专门安排的诊所就诊了633名患者，有197名患者需要进行程序。\ ud \ udLearnings \ ud自2008年该程序开始以来，等待访问的时间专家任命从八年减少到两年。此处描述的过程可以跨多个专业领域实现，可以在转诊中心的例程中交付，并且可以在长等待列表中识别需要程序的人数。

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