Improving Clinic Access for Urgent Urology Referrals.

Abstract

Objective: To improve access to the general urology clinics for urgent urology referrals. The issue of healthcare accessibility is relevant to urology, since certain urologic conditions require urgent assessment. Despite guidelines for timely assessment, challenges in clinic scheduling frequently cause patient care delays.

Methods: The prospective quality improvement study was conducted at outpatient general urology clinics from June 2023 to May 2024. An A3 quality improvement framework was used to develop, implement, and iterate on interventions intended to reduce wait times for urgent urology referrals. These included defining truly urgent diagnoses, streamlining referral template, allocating and protecting urgent clinic slots, and enhancing communication with multidisciplinary stakeholders.

Results: A total of 1058 urgent urology patients in the ambulatory setting were seen during the project timeframe. At baseline, mean wait time for urgent referrals was 59.0days, and 3 patients per week were seen within 10days of referral. Following implementation of interventions, the mean wait time decreased to 21.6 days, and 8 patients per week were seen within 10 days (P < .01). These processes were not associated with an adverse effect on wait times for routine referrals during the study.

Conclusion: Barriers to timely clinic access for urgent referrals include undefined definitions of urgency, lack of resource allocation dedicated for urgent patients, and lack of communication between referring providers, patient coordinators, and clinic staff. A streamlined referral process that addresses these issues can lead to significant and sustainable reduction in care delay for urgent urology patients.