A modified walk-in system versus scheduled appointments in a secondary-care prosthetic and orthotic clinic.
Gustav Jarl, Liselotte Hermansson
PMID 28905683WHAT IT FOUND
For shoe-insole patients, modified walk-in cut median wait from referral to appointment from 175 to 135 days, while adding 9.9 minutes in the waiting room.
Satisfaction did not change.
Key findings
01The primary outcome, indirect waiting time, was lower with modified walk-in (median 135 days) than with scheduled appointments (median 175 days).
02Patients attending modified walk-in had 9.9 minutes longer direct waiting time than patients attending scheduled appointments.
03Satisfaction with services did not differ significantly between patients attending modified walk-in or scheduled appointments.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The trial was done in one Swedish prosthetics and orthotics clinic with a small number of staff, so the result may not transfer to other settings. The two appointment systems were not fully comparable, especially in the first 4 months, when scheduled appointments had more new patients invited and used different appointment types. 75 patients were not randomized and were given scheduled appointments, including children under 13 years in the first 2 months. Direct waiting time was self-reported, and the time spent with each patient and the quality of the insoles were not documented. Questionnaire results came from 293 of 663 patients who attended the clinic, a 44.2% response rate, and respondents were older than non-respondents. More patients dropped out from modified walk-in than from scheduled appointments, and the study did not identify why most of them dropped out. Staff outcomes were based on 2 administrators and 6 of 7 prosthetists and orthotists, so they may not represent all staff.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not read this as evidence that any walk-in system will improve service. It cut median indirect waiting from 175 to 135 days but added 9.9 minutes in the waiting room, more patients dropped out from modified walk-in, and it was tested only in one Swedish prosthetics and orthotics clinic for shoe insoles.