Improving access in gastroenterology: the single point of entry model for referrals.

In 2005, a group of academic gastroenterologists in Calgary (Alberta) adopted a centralized referral intake system known as central triage. This system provided a single point of entry model (SEM) for referrals rather than the traditional system of individual practitioners managing their own referrals and queues. The goal of central triage was to improve wait times and referral management. In 2008, a similar system was developed in Edmonton at the University of Alberta Hospital (Edmonton, Alberta). SEMs have subsequently been adopted by numerous subspecialties throughout Alberta. There are many benefits of SEMs including improved access and reduced wait times. Understanding and measuring complex patient flow systems is key to improving access, and centralized intake systems provide an opportunity to better understand total demand and system bottlenecks. This knowledge is particularly important for specialties such as gastroenterology (GI), in which demand exceeds supply. While it is anticipated that SEMs will reduce wait times for GI care in Canada, the lack of sufficient resources to meet the demand for GI care necessitates additional strategies.

[1]  S. V. van Zanten,et al.  The 'natural history' of declined outpatient gastroenterology referrals. , 2012, Canadian journal of gastroenterology = Journal canadien de gastroenterologie.

[2]  G. W. Mitchell A Brief History of Triage , 2008, Disaster Medicine and Public Health Preparedness.

[3]  Cynthia Fraser,et al.  Interventions to improve outpatient referrals from primary care to secondary care. , 2008, The Cochrane database of systematic reviews.

[4]  Clarence K. Wong,et al.  The appropriateness of surveillance colonoscopy intervals after polypectomy. , 2013, Canadian journal of gastroenterology = Journal canadien de gastroenterologie.

[5]  D C Hadorn,et al.  Setting priorities for waiting lists: defining our terms. Steering Committee of the Western Canada Waiting List Project. , 2000, CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne.

[6]  R. Hunt,et al.  Access to specialist gastroenterology care in Canada: the Practice Audit in Gastroenterology (PAGE) Wait Times Program. , 2008, Canadian journal of gastroenterology = Journal canadien de gastroenterologie.

[7]  Kiok Liang Teow,et al.  Queueing for Healthcare , 2012, Journal of Medical Systems.

[8]  Robert Enns,et al.  Canadian Association of Gastroenterology position statement on screening individuals at average risk for developing colorectal cancer: 2010. , 2010, Canadian journal of gastroenterology = Journal canadien de gastroenterologie.

[9]  William G Paterson,et al.  Canadian consensus on medically acceptable wait times for digestive health care. , 2006, Canadian journal of gastroenterology = Journal canadien de gastroenterologie.

[10]  A. Barkun,et al.  Wait times for gastroenterology consultation in Canada: the patients' perspective. , 2010, Canadian journal of gastroenterology = Journal canadien de gastroenterologie.

[11]  P. Paavolainen,et al.  HOW TO REPORT AND MONITOR THE PERFORMANCE OF WAITING LIST MANAGEMENT , 2002, International Journal of Technology Assessment in Health Care.

[12]  S. Archer,et al.  Cardiac EASE (Ensuring Access and Speedy Evaluation) - the impact of a single-point-of-entry multidisciplinary outpatient cardiology consultation program on wait times in Canada. , 2009, The Canadian journal of cardiology.

[13]  Bacchus Barua,et al.  Waiting Your Turn: Wait Times for Health Care in Canada, 2012 Report , 2010 .

[14]  K. Bodger Cost of Illness of Crohn’s Disease , 2012, PharmacoEconomics.

[15]  I. Beck Disproportion of economic impact, research achievements and research support in digestive diseases in Canada. , 2001, Clinical and investigative medicine. Medecine clinique et experimentale.

[16]  Harminder Singh,et al.  Survey of access to gastroenterology in Canada: the SAGE wait times program. , 2010, Canadian journal of gastroenterology = Journal canadien de gastroenterologie.

[17]  W. Paterson,et al.  Wait time for endoscopic evaluation at a Canadian tertiary care centre: comparison with Canadian Association of Gastroenterology targets. , 2008, Canadian journal of gastroenterology = Journal canadien de gastroenterologie.

[18]  D. Armstrong,et al.  The 2012 SAGE wait times program: Survey of Access to GastroEnterology in Canada. , 2013, Canadian journal of gastroenterology = Journal canadien de gastroenterologie.

[19]  J. Chao,et al.  Effect of adalimumab on work productivity and indirect costs in moderate to severe Crohn's disease: a meta-analysis. , 2011, Canadian journal of gastroenterology = Journal canadien de gastroenterologie.

[20]  N. Taffinder,et al.  The impact of national guidelines on the waiting list for colonoscopy: a quantitative clinical audit , 2009, Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland.