| Ramchandani et al (2002)5 | Acceptability
Pts: 82% of Pts expressed willingness to change consultants in order to get an earlier operation by a surgeon of equal quality GPs: 92% favoured pooled lists; 8% were against Consultant ophthalmologists: 30% favoured (for routine cases) and 67% were against pooled
|
Small sample sizes for Pts and GPs Low response consultant survey (64%)—views of responders may differ from those of non-responders (non-response bias) Views of urban GPs may not reflect those of rural GPs
|
| Leach et al (2004)33 | Accessibility
Time from scan to outpatient review (total WT) was initially 185 days, reduced to 30 days following use of pooled lists Before introduction of pooled waiting lists, 37% of Pts waited for more than 9 months—this fell to 0
|
Limited data presented Source of preimplementation/postimplementation data not clear Total number of Pts, WT1 and WT2 data is not available
|
| Singh et al (2005)31 | Accessibility
Waiting lists for the selected procedures were cleared, especially longest waiters Pt throughput improved; number of the selected surgical procedures performed doubled
Cost: operating costs were reduced by 25% (largely due to reduced length of stay); no recorded adverse Pt outcomes Acceptability
|
Small scale complex intervention with many variables, difficult to assess association between WT reduction and use of single-entry components No definitions or data provided for waiting times Comparison of groups from different populations; survey sent to one group (control group based on historical data) Low questionnaire response rate—no measure of overall satisfaction; probable non-response bias
|
| Sir-Ram et al (2005)32 | Accessibility
Mean total WT from referral to surgery in group 1 (direct booking service) was 70 days (range 10–177), much shorter than for group 2 (control) Group 2 mean WT1 was 77 days; WT2 84.2 days, total WT 161.2 days (p<0.05)
Acceptability
|
Survey only sent to one group (control group was based on historical data) Comparison of groups from different populations Low questionnaire response rate Probable non-response bias
|
| Vasilakis et al (2007)30 | Accessibility
Pooled lists reduced mean number of Pts waiting on the list by 30%, compared with individual referrals Twice as many Pts had appointments within 12 weeks of referral through pooled vs individual surgeon referrals Pooled referrals reduced WT1 among longest waiters Pooled referrals increased WT2 for non-urgent cases; no impact on urgent and semiurgent Pts or on total WT Regardless of referral method, odds of surgery for Pts was equal within 18 weeks
|
|
| Bungard et al (2008)26 |
New collaborative model involves a single point-of-entry, intake and triage mechanism with a multidisciplinary team to ensure only one visit (rather than repeated) with cardiologist Traditional referral patterns still respected
|
|
| Cipriano et al (2008)27 | Accessibility
Clinically prioritising Pts reduced WTs for high-priority Pts and increased the number of Pts in all priority levels receiving surgery within maximum recommended WTs 90% of Pts received surgery within benchmark—achieved 1 year earlier
Efficiency/equity
Common waiting lists resulted in increased efficiency, equity in WT across regions and reduced waiting times in the long term Regional variation in WTs was reduced
|
|
| Bichel et al (2009)24 | Accessibility
Participating clinics demonstrated varying results Centralised access and triage decreased WTs and enabled timely access for Pts requiring urgent care (seen based on urgency rather than for specific surgeon) WTs decreased in spite of increased number of monthly Pt referrals and acceptance rate for most clinics WTs for consultation decreased from a mean (SD) of 29 (±46) to 17 (±14) days (p<0.05) for urgent-level referrals, from 110 (±57) to 63 (±42) days (p<0.00005) for moderate-level referrals, and from 155 (±88) to 108 (±37) days for routine-level referrals, respectively, between 2005 and 2008
Efficiency: pooling of referrals eliminated duplicate referralsEquity: WTs for each physician equalised |
Limited description of methods employed Sampling technique, sample size not provided Preimplementation data (for comparisons) was not available for all groups
|
| Bungard et al (2009)25 | Accessibility
Pts were seen significantly sooner in each year of Cardiac EASE compared with pre-EASE period (p<0.0001) The mean WT from referral to specialist consultation (WT1) was reduced from 71±45 days in the pre-EASE group to 33±19 days in the EASE group (p<0.0001) Cardiac EASE Pts had a significantly shorter wait to definitive diagnostic decision and treatment plan (WT2) compared with pre-EASE (51± days and 120±86 days, respectively) Increased Pt volume through Cardiac EASE (∼50% from 2004 to 2005; 19% from 2005 to 2006)
|
Complex intervention with many variables, difficult to assess association between WT reduction and use of single-entry components Comparison of groups from different populations Historical group has a small sample size compared with that of the intervention group Treatment effect may be present
|
| Macleod et al (2009)28 | Accessibility
|
|
| van den Heuvel (2012)29 | Accessibility
94/236 (40%) Pts responded—67% had the same surgeon for assessment and surgery; 31% had a different surgeon (next-available) Almost half of respondents (48%) did not understand that choosing a specific surgeon may result in longer waiting times No difference in postoperative complication rates between groups WTs from referral to initial consult in the hernia clinic (WT1) decreased from 208 to 59 days (2007–2009)
Acceptability
Two thirds of Pts had confidence in the competence of any surgeon and were comfortable having their surgery performed by a surgeon they meet on the day of surgery Even if Pts have a different surgeon for their operation than for their assessment, their confidence is high (86.2%) Most Pts felts that service is faster and better in a specialised centre (like the hernia clinic being evaluated)
|
|