Evidence map›Paper›PMID 35728864›Full record

ArticleBMJ open quality2022

Limited waiting areas in outpatient clinics: an intervention to incorporate the effect of bridging times in blueprint schedules.

Sander Dijkstra, Maarten Otten, Gréanne Leeftink, Bas Kamphorst, Angelique Olde Meierink, Anouk Heinen, Rhodé Bijlsma, Richard J Boucherie

Open access · goldAbstract read
In one paragraph

Article in BMJ open quality, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.8field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Sander DijkstraCenter for Healthcare Operations Improvement and Research (CHOIR), University of Twente, Enschede, Overijssel, The Netherlands.
Maarten OttenCenter for Healthcare Operations Improvement and Research (CHOIR), University of Twente, Enschede, Overijssel, The Netherlands.
Gréanne LeeftinkCenter for Healthcare Operations Improvement and Research (CHOIR), University of Twente, Enschede, Overijssel, The Netherlands a.g.leeftink@utwente.nl.ORCID 0000-0001-8835-5874
Bas KamphorstRhythm BV, Amsterdam, The Netherlands.
Angelique Olde MeierinkUniversity Medical Center Utrecht, Utrecht, The Netherlands.
Anouk HeinenSint Maartenskliniek, Nijmegen, Gelderland, The Netherlands.
Rhodé BijlsmaDepartment of Medical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands.
Richard J BoucherieCenter for Healthcare Operations Improvement and Research (CHOIR), University of Twente, Enschede, Overijssel, The Netherlands.
University of Twente · NLUniversity Medical Center Utrecht · NLSint Maartenskliniek · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDistancing measures enforced by the COVID-19 pandemic impose a restriction on the number of patients simultaneously present in hospital waiting areas.

objectiveEvaluate waiting area occupancy of an intervention that designs clinic blueprint schedules, in which all appointments of the pre-COVID-19 case mix are scheduled either digitally or in person under COVID-19 distancing measures, whereby the number of in-person appointments is maximised.

methodsPreintervention analysis and prospective assessment of intervention outcomes were used to evaluate the outcomes on waiting area occupancy and number of in-person consultations (postintervention only) using descriptive statistics, for two settings in the Rheumatology Clinic of Sint Maartenskliniek (SMK) and Medical Oncology & Haematology Outpatient Clinic of University Medical Center Utrecht (UMCU). Retrospective data from October 2019 to February 2020 were used to evaluate the pre-COVID-19 blueprint schedules. An iterative optimisation and simulation approach was followed, based on integer linear programming and Monte Carlo simulation, which iteratively optimised and evaluated blueprint schedules until the 95% CI of the number of patients in the waiting area did not exceed available capacity.

resultsUnder pre-COVID-19 blueprint schedules, waiting areas would be overcrowded by up to 22 (SMK) and 11 (UMCU) patients, given the COVID-19 distancing measures. The postintervention blueprint scheduled all appointments without overcrowding the waiting areas, of which 88% and 87% were in person and 12% and 13% were digitally (SMK and UMCU, respectively).

conclusionsThe intervention was effective in two case studies with different waiting area characteristics and a varying number of interdependent patient trajectory stages. The intervention is generically applicable to a wide range of healthcare services that schedule a (series of) appointment(s) for their patients. Care providers can use the intervention to evaluate overcrowding of waiting area(s) and design optimal blueprint schedules to continue a maximum number of in-person appointments under pandemic distancing measures.

Indexed as

COVID-19Ambulatory Care FacilitiesHumansPandemicsProspective StudiesRetrospective StudiesCOVID-19Decision support, computerisedEfficiency, OrganizationalOutpatientsSimulation

Identifiers

PMID35728864
PMCPMC9214409
OpenAlexW4283207642

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.