title: From blacklist to beacon, a case study in reducing dermatology out-patient waiting times.
abstract: At its worst our dermatology department had a waiting list for routine appointments of 57 weeks. As a result we started to lose contract income and consequently were unable to replace a retiring consultant. The service faced fragmentation and loss of the inpatient ward. Using a series of internally planned and driven initiatives it was possible to retrieve the situation. Our efforts were recognized by a national waiting list Beacon award in 1999. This study describes the methods used to increase new patient throughput, reduce demand and hence reduce waiting time for new patient appointments. Change was achieved only when medical, nursing staff, general practitioners, managers and health authorities were involved in the process. The changes needed to be led by a consultant enthusiast and managed effectively. There remains a constantly increasing demand for the service and reducing the waiting list simply invites a further increase in referral. In a resource-limited health care system the provider must be able to limit demand by using agreed referral exclusion criteria in order to balance supply and demand.
authors.affiliation: Department of Dermatology, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
authors.forename: A
authors.initials: A
authors.lastname: Appleby
authors.forename: C
authors.initials: C
authors.lastname: Lawrence
mesh_terms: D000556:Ambulatory Surgical Procedures; D001071:Appointments and Schedules; D003880:Dermatology / Q000458:organization & administration* / Q000706:statistics & numerical data; D004739:England; D006801:Humans; D008545:Melanoma / Q000175:diagnosis; D009720:Nurse Clinicians; D009936:Organizational Innovation; D010044:Outpatient Clinics, Hospital / Q000458:organization & administration*; D012017:Referral and Consultation; D012657:Self-Help Groups; D012878:Skin Neoplasms / Q000175:diagnosis; D014850:Waiting Lists; D000078329:Workforce