Recommendations from parents, administrative staff and clinicians to improve paediatric ambulatory appointment scheduling.
communication
family-centred services
health services
parent perceptions
qualitative research methods
Journal
Child: care, health and development
ISSN: 1365-2214
Titre abrégé: Child Care Health Dev
Pays: England
ID NLM: 7602632
Informations de publication
Date de publication:
11 2021
11 2021
Historique:
revised:
28
01
2021
received:
02
07
2020
accepted:
17
06
2021
pubmed:
26
6
2021
medline:
12
11
2021
entrez:
25
6
2021
Statut:
ppublish
Résumé
Stakeholders can provide valuable input to improve scheduling paediatric ambulatory clinic appointments, a complex process that requires effective planning and communication between parents, administrative staff and clinicians. The purpose of our study was to characterize recommendations from parents, administrative staff and clinicians to improve paediatric ambulatory appointment scheduling. Conducted between February 2018 and January 2019, this qualitative study was guided by qualitative description. Data collection was completed using focus groups with three stakeholder groups: parents, administrative staff and clinicians. Participants provided recommendations to optimize paediatric ambulatory appointment scheduling at the Stollery Children's Hospital in Edmonton, Alberta, Canada. Focus group data were transcribed verbatim and analysed using manifest inductive content analysis. Forty-six participants (mean age: 42.7; 87% female) participated in 12 focus groups. Parents (n = 11), administrative staff (n = 22) and clinicians (n = 13) made recommendations that were organized into two categories: appointment triaging and arranging. Triaging recommendations were related to appointment availability (e.g. providing alternatives to cancelling clinics with short notice) and waitlist management (e.g. developing clear and consistent policies regarding information flow and communication between clinics and administrative staff). Appointment arranging recommendations referred to booking (e.g. directly involving parents in the booking process), reminders (e.g. using text message reminders) and attendance (e.g. providing parents with a single point of contact who can provide the correct information about late and cancellation policies). Recommendations were similar across stakeholder groups. Our findings showed congruent recommendations across stakeholder groups to address challenges with scheduling ambulatory appointments, many of which have the potential to be modified. Experimental research and quality improvement initiatives are needed to determine the feasibility, acceptability and effectiveness of stakeholder recommendations to improve triaging and scheduling paediatric ambulatory appointments.
Sections du résumé
BACKGROUND
Stakeholders can provide valuable input to improve scheduling paediatric ambulatory clinic appointments, a complex process that requires effective planning and communication between parents, administrative staff and clinicians. The purpose of our study was to characterize recommendations from parents, administrative staff and clinicians to improve paediatric ambulatory appointment scheduling.
METHODS
Conducted between February 2018 and January 2019, this qualitative study was guided by qualitative description. Data collection was completed using focus groups with three stakeholder groups: parents, administrative staff and clinicians. Participants provided recommendations to optimize paediatric ambulatory appointment scheduling at the Stollery Children's Hospital in Edmonton, Alberta, Canada. Focus group data were transcribed verbatim and analysed using manifest inductive content analysis.
RESULTS
Forty-six participants (mean age: 42.7; 87% female) participated in 12 focus groups. Parents (n = 11), administrative staff (n = 22) and clinicians (n = 13) made recommendations that were organized into two categories: appointment triaging and arranging. Triaging recommendations were related to appointment availability (e.g. providing alternatives to cancelling clinics with short notice) and waitlist management (e.g. developing clear and consistent policies regarding information flow and communication between clinics and administrative staff). Appointment arranging recommendations referred to booking (e.g. directly involving parents in the booking process), reminders (e.g. using text message reminders) and attendance (e.g. providing parents with a single point of contact who can provide the correct information about late and cancellation policies). Recommendations were similar across stakeholder groups.
CONCLUSION
Our findings showed congruent recommendations across stakeholder groups to address challenges with scheduling ambulatory appointments, many of which have the potential to be modified. Experimental research and quality improvement initiatives are needed to determine the feasibility, acceptability and effectiveness of stakeholder recommendations to improve triaging and scheduling paediatric ambulatory appointments.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
834-843Subventions
Organisme : Women and Children's Health Research Institute
Informations de copyright
© 2021 John Wiley & Sons Ltd.
Références
Andrews, R., Morgan, J. D., Addy, D. P., & McNeish, A. S. (1990). Understanding nonattendance in outpatient paediatric clinics. Archives of Diseases in Children, 65, 192-195. https://doi.org/10.1136/adc.65.2.192
Ballantyne, M., Liscumb, L., Brandon, E., Jaffar, J., Macdonald, A., & Beaune, L. (2019). Mothers' perceived barriers to and recommendations for health care appointment keeping for children who have cerebral palsy. Global Qualitative Nursing Research, 6, 233339361986897. https://doi.org/10.1177/2333393619868979
Bohnhoff, J. C., Taormina, J. M., Ferrante, L., Wolfson, D., & Ray, K. N. (2019). Unscheduled referrals and unattended appointments after pediatric subspecialty referral. Pediatrics, 144, e20190545. https://doi.org/10.1542/peds.2019-0545
Bowman, R. J., Bennett, H. G., Houston, C. A., Aitchison, T. C., & Dutton, G. N. (1996). Waiting times for and attendance at paediatric ophthalmology outpatient appointments. BMJ, 313, 1244. https://doi.org/10.1136/bmj.313.7067.1244
Brown, E. E., Schwartz, M., Shi, C., Carter, T., Shea, J. A., Grande, D., & Chaiyachati, K. H. (2020). Understanding why urban, low-income patients miss primary care appointments: Insights from qualitative interviews of west Philadelphians. Journal of Ambulatory Care Management, 43, 30-40. https://doi.org/10.1097/JAC.0000000000000316
Cameron, E. L. (2014). A mixed methods investigation of parental factors in non-attendance at a general paediatric hostpial outpatient appointments. Aston University.
Cayirli, T., & Veral, E. (2003). Outpatient scheduling in health care: A review of the literature. Production and Operations Management, 12, 519-549. https://doi.org/10.1111/j.1937-5956.2003.tb00218.x
Cayirli, T., Veral, E., & Rosen, H. (2006). Designing appointment scheduling systems for ambulatory care services. Health Care Management Science, 9, 47-58. https://doi.org/10.1007/s10729-006-6279-5
Christie-Johnston, C., O'Loughlin, R., & Hiscock, H. (2020). ‘Getting to clinic study’: A mixed methods study of families who fail to attend hospital outpatient clinics. Journal of Paediatrics and Child Health, 56, 506-511. https://doi.org/10.1111/jpc.14672
Davies, E., Shaller, D., Edgman-Levitan, S., Safran, D. G., Oftedahl, G., Sakowski, J., & Cleary, P. D. (2008). Evaluating the use of a modified CAHPS® survey to support improvements in patient-centred care: Lessons from a quality improvement collaborative. Health Expectations, 11, 160-176. https://doi.org/10.1111/j.1369-7625.2007.00483.x
Drewek, R., Mirea, L., & Adelson, P. D. (2017). Lead time to appointment and no-show rates for new and follow-up patients in an ambulatory clinic. Health Care Management (Frederick), 36, 4-9. https://doi.org/10.1097/HCM.0000000000000148
Dunnill, M., & Pounder, R. (2004). Medical outpatients: Changes that can benefit patients. Clinical Medicine, 4, 45-49. https://doi.org/10.7861/clinmedicine.4-1-45
Foronda, C., MacWilliams, B., & McArthur, E. (2016). Interprofessional communication in healthcare: An integrative review. Nurse Education in Practice, 19, 36-40. https://doi.org/10.1016/j.nepr.2016.04.005
Greenhalgh, T., Robert, G., Bate, P., Kyriakidou, O., Macfarlane, F., & Peacock, R. (2004). How to spread good ideas: A systematic review of the literature on diffusion, dissemination and sustainability of innovations in health service delivery and organisation. Report for the National Co-ordinating Centre for NHS Service Delivery and Organisation R & D (NCCSDO). http://www.netscc.ac.uk/hsdr/files/project/SDO_FR_08-1201-038_V01.pdf (Accessed 04 November 2020).
Hampl, S., Paves, H., Laubscher, K., & Eneli, I. (2011). Patient engagement and attrition in pediatric obesity clinics and programs: Results and recommendations. Pediatrics, 128(Supplement 2), S59-S64. https://doi.org/10.1542/peds.2011-0480E
Harding, K. E., Robertson, N., Snowdon, D. A., Watts, J. J., Karimi, L., O'Reilly, M., Kotis, M., & Taylor, N. F. (2018). Are wait lists inevitable in subacute ambulatory and community health services? A qualitative analysis. Australian Health Review, 42, 93-99. https://doi.org/10.1071/AH16145
Health Quality Council of Alberta. (2018). Alberta quality matrix for health. www.hqca.ca (Accessed November 10, 2020).
Hirani, N., Karafillakis, E. N., & Majeed, A. (2016). Why children do not attend their appointments: Is there a need for an interface between general practitioners and hospitals allowing for the exchange of patients' contact details? JRSM Open, 7, 2054270416648046. https://doi.org/10.1177/2054270416648046
Hsieh, H. F., & Shannon, S. E. (2005). Three approaches to qualitative content analysis. Qualitative Health Research, 15, 1277-1288. https://doi.org/10.1177/1049732305276687
Leeftink, A. G., Bikker, I. A., Vliegen, I. M. H., & Boucherie, R. J. (2018). Multi-disciplinary planning in health care: A review. Health Systems, 9, 95-118. https://doi.org/10.1080/20476965.2018.1436909
Mayan, M. J. (2009). Essentials of qualitative inquiry. BiblioVault OAI Repository, University of Chicago.
McClure, R. J., Newell, S. J., & Edwards, S. (1996). Patient characteristics affecting attendance at general outpatient clinics. Archives of Diseases in Children, 74, 121-125. https://doi.org/10.1136/adc.74.2.121
Naiker, U., FitzGerald, G., Dulhunty, J. M., & Rosemann, M. (2018). Time to wait: A systematic review of strategies that affect out-patient waiting times. Australian Health Review, 42, 286. https://doi.org/10.1071/AH16275
Oudhoff, J. P., Timmermans, D. R. M., Knol, D. L., Bijnen, A. B., & Van der Wal, G. (2007). Prioritising patients on surgical waiting lists: A conjoint analysis study on the priority judgements of patients, surgeons, occupational physicians, and general practitioners. Social Science & Medicine, 64, 1863-1875. https://doi.org/10.1016/j.socscimed.2007.01.002
Patton, M. Q. (2015). Qualitative research & evaluation methods: Integrating theory and practice (4th ed.). SAGE.
Quintanilha, M., Tink, L., Perez, A., O'Neill, M., Holt, N. L., Bruce, A., Childs, M., Kane-Poitras, S., Kherani, T., Ladha, T., Majaesic, C., Webber, M., & Ball, G. D. C. (2020). Pediatric ambulatory appointment scheduling: A qualitative study of stakeholders' perceptions and experiences. International Journal for Quality in Health Care, 32, 643-648. https://doi.org/10.1093/intqhc/mzaa105
Ray, K. N., Ashcraft, L. E., Kahn, J. M., Mehrotra, A., & Miller, E. (2016). Family perspectives on high-quality pediatric subspecialty referrals. Academic Pediatrics, 16, 594-600. https://doi.org/10.1016/j.acap.2016.05.147
Richards, L., & Morse, J. M. (2013). Read me first for a user's guide to qualitative methods (3rd ed.). Sage.
Røthing, M., Malterud, K., & Frich, J. C. (2015). Family caregivers' views on coordination of care in Huntington's disease: A qualitative study. Scandinavian Journal of Caring Sciences, 29, 803-809. https://doi.org/10.1111/scs.12212
Sandelowski, M. (2000). Whatever happened to qualitative description? Research in Nursing and Health, 23, 334-340. https://doi.org/10.1002/1098-240X(200008)23:4%3C334::AID-NUR9%3E3.0.CO;2-G
Sharp, D. J., & Hamilton, W. (2001). Non-attendance at general practices and outpatient clinics: Local systems are needed to address local problems. BMJ, 323, 1081-1082. https://doi.org/10.1136/bmj.323.7321.1081
Tashakkori, A., & Teddlie, C. (Eds.) (2003). Handbook of mixed methods in the social and behavioral sciences. SAGE Publications.
Touch, J., & Berg, J. P. (2016). Parent perspectives on appointment nonattendance: A descriptive study. Pediatric Nursing, 42, 181-188.
Weissenstein, A., Straeter, A., Villalon, G., Luchter, E., & Bittmann, S. (2011). Parent satisfaction with a pediatric practice in Germany: A questionnaire-based study. Italian Journal of Pediatrics, 37, 31. https://doi.org/10.1186/1824-7288-37-31
Wilkins, A. (2018). A review of centralized scheduling implementation in pediatric ambulatory care. University of Pittsburgh.
Wojtys, E. M., Schley, L., Overgaard, K. A., & Agbabian, J. (2009). Applying lean techniques to improve the patient scheduling process. Journal for Healthcare Quality, 31, 10-16. https://doi.org/10.1111/j.1945-1474.2009.00025.x
Wolthers, O. D. (2019). Differential effects of text message reminders on non-attendance and late cancellations in a paediatric outpatient clinic. Danish Medical Journal, 66, A5575.