title: Effects of problem-based scheduling on patient waiting and staff utilization of time in a pediatric clinic.
abstract: The patient scheduling system in a pediatric outpatient clinic was changed from time-based to problem-based in an A-B-A-B reversal design. During baseline, time-based scheduling was in effect with patients being scheduled in 15-min periods regardless of presenting problem. During intervention, a receptionist matched client problems with time slots so that a more extensive treatment was allocated more time. Problem-based scheduling resulted in a substantial decrease in mean number of minutes spent in clinic across all presenting problems. Waiting time increased to baseline levels when problem-based scheduling was removed and decreased again on reintroduction of the program. A follow-up check conducted 1 month after the end of the second intervention phase revealed that the effects were maintained. The problem-based schedule also resulted in an increase in the proportion of extra time that medical staff had available and produced a positive consumer response.
mesh_terms: D000553:Ambulatory Care; D001071:Appointments and Schedules; D002648:Child; D006801:Humans; D012017:Referral and Consultation; D013997:Time Factors