EFFECTS OF PROBLEM‐BASED SCHEDULING ON PATIENT WAITING AND STAFF UTILIZATION OF TIME IN A PEDIATRIC CLINIC

Abstract

The patient scheduling system in a pediatric outpatient clinic was changed from time‐based to problem‐based in an A‐B‐A‐B reversal design. During baseline, time‐based scheduling was in effect with patients being scheduled in 15‐min periods regardless of presenting problem. During intervention, a receptionist matched client problems with time slots so that a more extensive treatment was allocated more time. Problem‐based scheduling resulted in a substantial decrease in mean number of minutes spent in clinic across all presenting problems. Waiting time increased to baseline levels when problem‐based scheduling was removed and decreased again on reintroduction of the program. A follow‐up check conducted 1 month after the end of the second intervention phase revealed that the effects were maintained. The problem‐based schedule also resulted in an increase in the proportion of extra time that medical staff had available and produced a positive consumer response.