PubMed · 6800503
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S Arber, L Sawyer. 1982-02-13. Do appointment systems work?. https://doi.org/10.1136/bmj.284.6314.478
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AIMS: To examine waiting times, reasons for waiting, and patient knowledge of those reasons, in the emergency department (ED). METHODS: Data were collected on patients presenting to the emergency department over 7 weeks. Those who waited more than 30 minutes in the waiting room or more than 2 hours in the total department were studied further. RESULTS: Thirty seven percent exceeded the times above (group A). Mean times for this group were 175 mins. Only 7% stayed in the waiting room more than 30 minutes. Delays were related to doctors (42%), waiting for tests and results (16%), prolonged treatment and assessment (12%), and other reasons (30%). Only 47% were clear about why they were waiting. CONCLUSIONS: Some extended waiting is appropriate. Unnecessary delays are common and can be avoided by attention to facilities, improving deployment of staff, and removal of bottlenecks in testing procedures. Waiting time in emergency departments will alter as observation wards and definitive treatments by emergency specialists increase. The public will need to be fully informed as these changes take place.
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Case manager responses to failed appointments were monitored for 83 seriously mentally ill persons in a rural community mental health center. Case manager actions taken were grouped into four categories of follow-up from most intensive to least intensive: home visit, phone call, letter, and no follow-up. On the whole, case managers most frequently did not follow-up missed appointments (56.7%), followed up by letters (21.3%), and telephone calls (18.7%), and home visits (3.3%). Analyses revealed that home visits were most intensive and all clients who were visited following failed appointments did not fail the subsequent appointment. Clients who received telephone calls or letters were about equally likely to fail the subsequent appointment, but were much more likely to attend the subsequent appointment than were clients who received no follow-up to the failed appointment. Interestingly, clients who failed appointments and received no follow-up were much more likely to need emergency services rather than a regular appointment as their next contact with the clinic.