title: Reducing waiting time for community rehabilitation services: a controlled before-and-after trial.
abstract: OBJECTIVE
  To investigate whether a simple alternative (specific timely appointments for triage [STAT]) to the more common approach of managing demand using a waitlist with a triage system could reduce waiting time for a community rehabilitation program (CRP) without adverse impacts on patient care.
  
  
  METHODS
  A prospective, controlled before-and-after trial. Preintervention and postintervention data were collected for 6 months in 2 consecutive years. STAT was introduced at an intervention site and compared with a control site using a triaged waitlist.
  
  
  METHODS
  Two musculoskeletal CRP teams within a large metropolitan health service.
  
  
  METHODS
  All patients referred to both sites during periods preintervention (n=483) and postintervention (n=488).
  
  
  METHODS
  Under STAT, clinicians created a specified number of assessment times each week based on average referral numbers, and patients were immediately allocated an appointment on referral.
  
  
  METHODS
  The primary outcome was the time from referral to first appointment; secondary outcomes included program duration, quality-of-life scores (using the EuroQol EQ-5D), and unplanned hospital admissions.
  
  
  RESULTS
  Waiting time decreased from a mean of 17.5 days to 10.0 days (P<.01) at the intervention site, with no significant change at the control site. Intervention site patients were over 3 times more likely to be seen within 7 days than control site patients (odds ratio, 3.3; 95% confidence interval, 2.2-4.9). Secondary outcomes did not differ significantly between groups.
  
  
  CONCLUSIONS
  A simple alternative to using a triaged waitlist to manage CRP referrals reduced waiting time without adversely affecting care. Results were sustained over 6 months with no additional resources.
authors.affiliation: Faculty of Health Sciences, La Trobe University, Melbourne, Australia; Allied Health Research Office, Eastern Health, Melbourne, Australia. katherine.harding@easternhealth.org.au
authors.forename: Katherine E
authors.initials: KE
authors.lastname: Harding
authors.forename: Sandra G
authors.initials: SG
authors.lastname: Leggat
authors.forename: Birgitte
authors.initials: B
authors.lastname: Bowers
authors.forename: Maree
authors.initials: M
authors.lastname: Stafford
authors.forename: Nicholas F
authors.initials: NF
authors.lastname: Taylor
mesh_terms: D000368:Aged; D003153:Community Health Services / Q000458:organization & administration / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility / Q000458:organization & administration / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D010348:Patient Care Team; D011446:Prospective Studies; D011788:Quality of Life; D012017:Referral and Consultation; D012047:Rehabilitation Centers / Q000458:organization & administration / Q000706:statistics & numerical data*; D013997:Time Factors; D014218:Triage; D014850:Waiting Lists