Frédérique Dupuis1, Julien Déry1, Fabio Carlos Lucas de Oliveira1, Ana Tereza Pecora1, Rose Gagnon1, Katherine Harding2, Chantal Camden3, Jean-Sébastien Roy1, Josiane Lettre1, Anne Hudon4, Marie Beauséjour5, Anne-Marie Pinard6, Brenna Bath7, Simon Deslauriers1, Marie-Ève Lamontagne1, Debbie Feldman4, François Routhier1, François Desmeules4, Luc J Hébert1, Jordan Miller8, Angel Ruiz9, Kadija Perreault1. 1. Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), 560498Centre intégré universitaire de santé et de services sociaux (CIUSSS) de la Capitale-Nationale, Québec, Canada. 2. Allied Health Clinical Research Office, Eastern Health, Victoria, Australia. 3. École de réadaptation, Faculté de médecine et des sciences de la santé, 12370Université de Sherbrooke, Sherbrooke, QC, Canada. 4. École de Réadaptation, 12368Université de Montréal, Montreal, QC, Canada. 5. Département des Sciences de la santé communautaire, 7321Université de Sherbrooke, Longueuil, QC, Canada. 6. Département D'anesthésiologie et de Soins Intensifs, Faculté de Médecine, 12369Université Laval, Québec, QC, Canada. 7. School of Rehabilitation Science, College of Medicine, 12371University of Saskatchewan, Saskatoon, SK, Canada. 8. School of Rehabilitation Therapy, Physical Therapy Program, 4257Queen's University, Kingston, ON, Canada. 9. Département d'opérations et systèmes de décision, Faculté des sciences de l'administration, 4440Université Laval, Québec, QC, Canada.
Abstract
OBJECTIVE: Identifying effective strategies to reduce waiting times is a crucial issue in many areas of health services. Long waiting times for rehabilitation services have been associated with numerous adverse effects in people with disabilities. The main objective of this study was to conduct a systematic literature review to assess the effectiveness of service redesign strategies to reduce waiting times in outpatient rehabilitation services for adults with physical disabilities. METHODS: We conducted a systematic review, searching three databases (MEDLINE, CINAHL and EMBASE) from their inception until May 2021. We identified studies with comparative data evaluating the effect of rehabilitation services redesign strategies on reducing waiting times. The Mixed Methods Appraisal Tool was used to assess the methodological quality of the studies. A narrative synthesis was conducted. RESULTS: Nineteen articles including various settings and populations met the selection criteria. They covered physiotherapy (n = 11), occupational therapy (n = 2), prosthetics (n = 1), exercise physiology (n = 1) and multidisciplinary (n = 4) services. The methodological quality varied (n = 10 high quality, n = 6 medium, n = 3 low); common flaws being missing information on the pre-redesign setting and characteristics of the populations. Seven articles assessed access processes or referral management strategies (e.g. self-referral), four focused on extending/modifying the roles of service providers (e.g. to triage) and eight changed the model of care delivery (e.g. mode of intervention). The different redesign strategies had positive effects on waiting times in outpatient rehabilitation services. CONCLUSIONS: This review highlights the positive effects of many service redesign strategies. These findings suggest that there are several effective strategies to choose from to reduce waiting times and help better respond to the needs of persons experiencing physical disabilities.
OBJECTIVE: Identifying effective strategies to reduce waiting times is a crucial issue in many areas of health services. Long waiting times for rehabilitation services have been associated with numerous adverse effects in people with disabilities. The main objective of this study was to conduct a systematic literature review to assess the effectiveness of service redesign strategies to reduce waiting times in outpatient rehabilitation services for adults with physical disabilities. METHODS: We conducted a systematic review, searching three databases (MEDLINE, CINAHL and EMBASE) from their inception until May 2021. We identified studies with comparative data evaluating the effect of rehabilitation services redesign strategies on reducing waiting times. The Mixed Methods Appraisal Tool was used to assess the methodological quality of the studies. A narrative synthesis was conducted. RESULTS: Nineteen articles including various settings and populations met the selection criteria. They covered physiotherapy (n = 11), occupational therapy (n = 2), prosthetics (n = 1), exercise physiology (n = 1) and multidisciplinary (n = 4) services. The methodological quality varied (n = 10 high quality, n = 6 medium, n = 3 low); common flaws being missing information on the pre-redesign setting and characteristics of the populations. Seven articles assessed access processes or referral management strategies (e.g. self-referral), four focused on extending/modifying the roles of service providers (e.g. to triage) and eight changed the model of care delivery (e.g. mode of intervention). The different redesign strategies had positive effects on waiting times in outpatient rehabilitation services. CONCLUSIONS: This review highlights the positive effects of many service redesign strategies. These findings suggest that there are several effective strategies to choose from to reduce waiting times and help better respond to the needs of persons experiencing physical disabilities.
Entities:
Keywords:
rehabilitation; service redesign strategies; waiting times
Authors: F Dupuis; K Perreault; L J Hébert; M Perron; Maj A Fredette; F Desmeules; J S Roy Journal: BMC Musculoskelet Disord Date: 2022-04-18 Impact factor: 2.562