Evidence map›Paper›PMID 39342263›Full record

ArticleBMC health services research2024

Criteria-based outpatient scheduling at a nephrology clinic: prospective evaluation of patient pre-assessment and its corresponding adaptive scheduling strategy.

Ruben Klaas, Jedidja Lok-Visser, Joan Doornebal, Ton Roelofs, Sebastian Rachuba, Gréanne Leeftink

Abstract read
In one paragraph

Article in BMC health services research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Ruben KlaasCenter for Healthcare Operations Improvement and Research (CHOIR), University of Twente, Drienerlolaan 5, Enschede, The Netherlands.
Jedidja Lok-VisserCenter for Healthcare Operations Improvement and Research (CHOIR), University of Twente, Drienerlolaan 5, Enschede, The Netherlands.
Joan DoornebalDepartment of Internal Medicine, Isala, Zwolle, The Netherlands.
Ton RoelofsDepartment of Internal Medicine, Isala, Zwolle, The Netherlands.
Sebastian RachubaCenter for Healthcare Operations Improvement and Research (CHOIR), University of Twente, Drienerlolaan 5, Enschede, The Netherlands.
Gréanne LeeftinkCenter for Healthcare Operations Improvement and Research (CHOIR), University of Twente, Drienerlolaan 5, Enschede, The Netherlands. a.g.leeftink@utwente.nl.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOutpatient Clinics (OCs) are under pressure because of increasing patient volumes and provider shortages. At the same time, many patients with chronic diseases receive routine follow-up consultations that are not always necessary. These patients block access to care for patients that are in actual need for care. Pre-assessing patient charts has shown to reduce unnecessary outpatient visits. However, the resulting late cancellations due to the pre-assessment, challenge efficient alignment of capacity with actual patient demand, leading to either empty slots or overtime. This study aims to develop a method to analyse the effect of pre-assessing patients before inviting them to the OC. This involves 1) to select who should come and 2) to optimize the impact of pre-assessment on the schedule and efficient use of OC staff.

methodsThis prospective mixed-methods evaluation study consists of 1) an expert meeting to determine a pre-assessment strategy; 2) a retrospective cohort study to review the impact of this strategy (12 months of a Dutch nephrology OC); 3) mathematical optimization to develop an optimal criteria-based scheduling strategy; and 4) a computer simulation to evaluate the developed strategy. Primary outcomes are the staff idle time and staff overtime. Secondary outcomes evaluate the number of weekly offered appointments.

resultsThe expert group reached consensus about the pre-assessment criteria. 875 (18%) of the realized appointments in 2022 did not meet the OC visit pre-assessment criteria. In the best performing scheduling strategy, 94 slots (87% of the available capacity) should be scheduled on a weekly basis. For this schedule, 26.8% of the OC weeks will experience idle time (

conclusionsThis evaluation study allows OC managers to virtually test operational impact of pre-assessment strategies on the capacity of their OC, and shows the potential of increasing efficient use of scarce healthcare capacity.

trial registrationNot applicable.

Indexed as

Ambulatory Care FacilitiesAppointments and SchedulesNephrologyEfficiency, OrganizationalFemaleHumansMaleMiddle AgedNetherlandsProspective StudiesRetrospective StudiesAppointmentsAvoidable assessmentsOutpatient clinicsPatient flowPlanning & schedulingPre-assessment

Identifiers

PMID39342263
PMCPMC11437885

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.