title: The effect of a non-surgical orthopaedic physician on wait times to see a paediatric orthopaedic surgeon.
abstract: OBJECTIVE
  High referral volumes to paediatric orthopaedic surgeons create long clinic waiting lists. The use of extended scope roles for doctors and health professionals is one strategy to address these wait times. We completed a 6-month trial of a non-surgical paediatric orthopaedic physician role (NSP) to help manage non-urgent referrals to our service from local general practitioners (GPs).
  
  
  METHODS
  For a 6-month period, the majority of non-urgent GP referrals were assessed by a US-trained NSP. Wait times were compared between this period and the same time period in the previous year. Family and referrer satisfaction was determined through postal surveys.
  
  
  RESULTS
  Over the trial period, the NSP saw a total of 155 new patient referrals, which represented 49% of all non-urgent GP referrals for the period. Before the trial, only 75% of non-urgent referrals were seen within 131 days (19 weeks) with 10% waiting more than 215 days (31 weeks). By the end of the trial, 75% of referrals were seen within 55 days (8 weeks) and 90% within 61 days (9 weeks). The most common outcome was discharge with management advice. 12% of patients were referred on to an orthopaedic surgeon but only 1% went on to a surgical wait list. Families and referrers reported high levels of satisfaction and only three patients discharged by the NSP were referred back for orthopaedic surgeon review.
  
  
  CONCLUSIONS
  The NSP role was effective at reducing clinic wait times for patients with non-urgent paediatric orthopaedic conditions, while maintaining family and referrer satisfaction.
authors: Department of Surgery, The University of Auckland, Auckland City, Auckland, New Zealand.
authors: Matthew
authors: M
authors: Bowman
authors: Anna
authors: A
authors: Mackey
authors: Nichola
authors: N
authors: Wilson
authors: Ngaire Susan
authors: NS
authors: Stott
mesh_terms: D000328:Adult; D001071:Appointments and Schedules; D002648:Child; D005190:Family / Q000523:psychology; D005260:Female; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D008875:Middle Aged; D009985:Orthopedics; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D010372:Pediatrics; D010820:Physicians / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D013038:Specialization / Q000706:statistics & numerical data; D066231:Surgeons / Q000706:statistics & numerical data*; D013997:Time Factors; D014850:Waiting Lists
keywords: general paediatrics; health workforce; orthophaedics