[Improvement of the management of outpatient consultations by a direct automatic citation of interconsultations].

OBJECTIVE: The delay caused to provide an appointment and the uncertainty of the expected waiting time, are cause for discontent in the patients. The object of this work was to improve the accessibility to the consultation of specialized attention in our health area, decreasing the average waiting time and reduce the number of claims for this reason.

METHODS: To measure the quality of the service provided, 5 criteria were developed and evaluated, by means of a cross section, in December 2015 for all patients pending appointment in the Area. Likewise, the complaints and claims collected during the 6 months prior to this date were quantified. As an intervention, a new circuit was designed and implemented in the interconsultation process, protocolizing a direct and automatic citation system. This system also eliminated patients without an appointment, allowing prioritization in preferred cases. At the end of 2016, a new evaluation was made with the same methodology. For the statistical analysis, Student's t and Chisquare were used.

RESULTS: In six months the number of patients without appointment was reduced from 4726 to 0. The average waiting time for external consultations improved from 63 to 44.2 days. Patients waiting more than 50 days increased from 41.5% to 74.8%. The number of complaints and claims due to appointment in external consultations decreased from 161 to 80.

CONCLUSIONS: Accessibility has improved by reducing the average waiting time and eliminating the list of patients without an appointment, although the number of patients pending appointments for more than 50 days has increased. The number of complaints and claims has been halved.