Selective Centralized Booking a Promising Concept
Selective centralized booking as a low cost alternative to centralized referral.
Many initiatives, including centralized referral systems, have been implemented to shorten surgical wait times and to equalize waitlists between surgeons within the same group. While some of these have proven successful, the expense of these projects makes them unsustainable once the funding ends. A pilot project of selective centralized booking for hernia repair was implemented at the Vernon Jubilee Hospital to decrease the wait time from referral to surgery and optimize utilization of available operating room time.
Methods
Patients were triaged by the surgeon to whom they were referred and then willing patients with open inguinal and open umbilical hernias who met criteria were booked with the first available surgeon. This required no additional funding from the health authority. The wait times and affect on the rate of underutilized OR time were analyzed.
Results:
Fully booked OR slates increased from 80% to 85% and ≥90% booked OR slates increased from 97.7% to 99%. The average wait time for inguinal and umbilical hernias decreased from 137 days (n=202, range 9-439) to 82 days (n=13, range 34-124), p<0.05, and 181 days (n=90, range 13-483) to 80 days (n=5, range 17-160) p<0.05, respectively.
Conclusion:
Selective centralized booking is a promising concept that has led to more efficient utilization of available OR time with a significant decrease in wait times, improving access for all general surgery patients without needing any additional funding.
—Taryn Zabolotniuk, Hamish Hwang