title: Are wait lists inevitable in subacute ambulatory and community health services? A qualitative analysis.
abstract: Objectives Wait lists are common in ambulatory and community-based services. The aim of the present study was to explore managers' perceptions of factors that contribute to wait times. Methods A qualitative study was conducted using semi-structured interviews with managers and team leaders of ambulatory and community health services within a large health network. Interviews were transcribed and coded, and the codes were then grouped into themes and subthemes. Results Representatives from 26 services participated in the project. Four major themes were identified. Three themes related to reasons and factors contributing to increased wait time for services (inefficient intake and scheduling processes; service disruptions due to human resource issues; and high service demand). A fourth theme related to staff attitudes towards wait times and acceptance and acknowledgement of wait lists. Conclusions Service providers perceive high demand to be a key driver of wait times, but a range of other factors also contributes and may represent opportunities for improving access to care. These other factors include improving process efficiencies, greater consistency of service delivery through more efficient management of human resources and shifting to more consumer-centred approaches in measuring wait times in order to drive improvements in patient flow. What is known about the topic? Wait times are common in out-patient and ambulatory services. These services experience high demand, which is likely to continue to grow as health service delivery shifts from hospital to community settings. What does this paper add? Although demand is an important driver of wait times, there are other modifiable factors that also contribute, including process inefficiencies and service disruption related to human resource issues. An underlying staff attitude of acceptance of wait times appears to be an additional barrier to improving access. What are the implications for practitioners? The findings of the present study suggest that there are opportunities for improving access to ambulatory and community health services through more efficient use of existing resources. However, a more consumer-focused approach regarding acceptability of wait times is needed to help drive change.
authors.affiliation: La Trobe University, Kingsbury Drive, Bundoora, Vic. 3086, Australia. Email:.
authors.forename: Katherine E
authors.initials: KE
authors.lastname: Harding
authors.affiliation: Eastern Health, 5 Arnold Street, Box Hill, Vic. 3128, Australia. Email: ;
authors.forename: Nicole
authors.initials: N
authors.lastname: Robertson
authors.affiliation: Eastern Health, 5 Arnold Street, Box Hill, Vic. 3128, Australia. Email: ;
authors.forename: David A
authors.initials: DA
authors.lastname: Snowdon
authors.affiliation: Centre for Population Health Research, Deakin University, 221 Burwood Highway, Burwood, Vic. 3125, Australia. Email.
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Watts
authors.affiliation: La Trobe University, Kingsbury Drive, Bundoora, Vic. 3086, Australia. Email:.
authors.forename: Leila
authors.initials: L
authors.lastname: Karimi
authors.affiliation: Eastern Health, 5 Arnold Street, Box Hill, Vic. 3128, Australia. Email: ;
authors.forename: Mary
authors.initials: M
authors.lastname: O'Reilly
authors.affiliation: Victorian Department of Health and Human Services, 50 Lonsdale Street, Melbourne, Vic. 3000, Australia. Email.
authors.forename: Michelle
authors.initials: M
authors.lastname: Kotis
authors.affiliation: La Trobe University, Kingsbury Drive, Bundoora, Vic. 3086, Australia. Email:.
authors.forename: Nicholas F
authors.initials: NF
authors.lastname: Taylor
mesh_terms: D000554:Ambulatory Care Facilities / Q000458:organization & administration*; D001071:Appointments and Schedules; D001291:Attitude of Health Personnel; D003153:Community Health Services / Q000458:organization & administration; D006282:Health Personnel / Q000523:psychology*; D006297:Health Services Accessibility; D006801:Humans; D007407:Interviews as Topic; D036301:Qualitative Research; D014218:Triage; D014739:Victoria; D014850:Waiting Lists