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Specialist Outpatient

Outpatient Indicators

Data Quality Statement

Information regarding specialist outpatient waiting times has not been routinely reported by Queensland Health before October 2012. Previous attempts to report accurate outpatient waiting times were hindered by the complex nature of information systems and inconsistent processes. Queensland Health recognises the importance of reporting accurate outpatient waiting times. As such, there has been considerable investment in resources to improve the information to a standard that provides an indication of the waiting times for the majority of public hospital patients. Further refinement and resolution of known data quality issues will be made at both the Departmental and Hospital and Health Service level to continue to improve the accuracy of the waiting times of patients. The current issues are considered to be minor and constitute a small proportion of the activity reported. At this time, Queensland Health determines that this data is fit for publication.

Outpatient access

You need a current referral from your general practitioner (GP) to obtain an appointment at a specialist outpatient clinic. Patients with the most urgent needs are seen first. The referral obtained from your General Practitioner will contain important information about your clinical condition that will allow the health practitioner in the outpatient clinic to determine the urgency of your condition and prioritisation for your appointment.

If you are attending a specialist outpatient clinic for a new health problem not previously treated by this clinic, you are considered to be requiring an 'initial service event'. Some patients may require follow up appointments for the same condition.

When you attend your specialist outpatient appointment, the specialist health team assess your condition and decide on the best course of treatment with you.


Waiting time

The start of the waiting time is the date a referral was received by the treating hospital.
The finish of the waiting time is the appointment date (for the 90th percentile wait) or the census date (for the percentage waiting within time).

The number of days between the start and the end of the waiting time is calculated first. Then excluded from this total is any days the patient was Not Ready For Care and any days the patient was waiting as a less urgent category and any days the referral cannot be progressed because the hospital is awaiting further information from the referring practitioner.

If a patient is offered an appointment and they cancel, or fail to show up for the appointment, their wait continues. At some clinics, as many as 1 in 4 patients fail to attend their appointment and many patients do not inform the hospital they are not coming. This means that not only does that patient have to wait longer for their appointment, but the appointment slot cannot be used for other patients, potentially extending their wait. This should be considered when interpreting these waiting times, and should be noted by patients who have been offered an appointment.

90th percentile waiting times (days) for a new case specialist appointment

How many days have 90% of people waited?

This is a performance measure for hospitals which indicates the normal waiting period. The table shows the number of days that 90% of patients waited for their initial specialist outpatient appointment. For example, if the 90th percentile wait for category 1 patients is 35 days, this means that 90% of category 1 patients waited 35 days or less, and there is a good chance that future category 1 patients may be seen within a similar number of days. The waiting time for each clinic shows the mix of patients.

Patients waiting within the clinically recommended time

Were the waiting times appropriate?

This is another performance measure that shows if hospitals provided patients with outpatient services within recommended timeframes for each urgency category. This measure shows, for each category, the percentage of patients waiting for an outpatient appointment at the census date who waited up to the maximum recommended time. The higher the percentage, the better the performance. The percentage for each clinic shows the mix of patients.

Clinics

The GP and patient decide on the appropriate clinic for referral dependent upon the patient's condition. Not all patients who attend a specialist clinic have been already diagnosed with a condition, but need to see a specialist to determine their diagnosis and a treatment plan. A variety of activities are done in outpatient clinics, including diagnosing, assessing, treating, educating, performing tests and doing procedures.

Cardiac Surgery - patients with a heart condition and who are likely to require surgery, or have recently had heart surgery, are seen by a cardiac specialist regarding their condition and treatment. Includes general, cardiothoracic and thoracic cardiac surgery.

Cardiology - patients with heart conditions such as heart disease, hypertension, and coronary artery and valve disease are seen in this clinic by a cardiologist to assess their condition and sometimes have tests such as ECG, CT or MRI. Includes general cardiology, Holter Clinic, stress tests, pacemaker and hypertension clinics.

Dermatology - a dermatologist assesses, diagnoses, treats and manages patients with skin conditions including skin cancer and skin allergies.

Diabetes - patients with diabetes have high blood sugar and require their condition to be reviewed and managed by an endocrinologist and are also taught how to manage living with diabetes.

Ear Nose and Throat - an ear, nose and throat (ENT) specialist consults with a range of patients with conditions usually requiring surgery such as tonsillectomies, sinus surgery, myringotomies (for ear infections) as well as people with Cochlear implants, throat conditions and head and neck cancers.

Endocrinology - an endocrinologist is a doctor who specialises in treating, managing and educating patients with endocrine, nutritional and metabolic disorders such as thyroid conditions, osteoporosis and menopause complications. While diabetes is an endocrine condition, patients attending diabetes clinics have been separated out from this Endocrinology group of patients for reporting of waiting times. Includes general, thyroid, metabolic and metabolic bone endocrinology clinics.

Gastroenterology - patients with diseases and disorders of the stomach and intestine such as ulcers, cancers, pancreatitis, liver disease, hepatitis, Crohn's disease and coeliac disease see a gastroenterologist.

General Medicine - a general medicine specialist looks after patients with a medical condition of their internal organs, often who have not yet been diagnosed, or to be treated for a specialised condition where the specialist clinic is not available.

General Surgery - a general surgeon consults with patients who are likely to require surgery, or have recently had surgery of internal organs, and generally deal with the torso. Includes general, breast and colorectal general surgery clinics.

Gynaecology - women attend this clinic to be assessed and treated for problems relating to their reproductive organs. Includes general gynaecology, gynae-oncology, menopause, colposcopy and pap smear clinics.

Neurology - a neurologist specialises in treating people with diseases of the brain, spinal cord and nerves, including patients with stroke and multiple sclerosis.

Neurosurgery - patients with a nervous system disorder and who are likely to require surgery, or have recently had surgery, are seen by a surgeon specialising in brain, spine and nerve surgery regarding their condition and treatment.

Nephrology - patients with conditions of the kidney and urinary tract are seen in this clinic by a nephrologist or a renal nurse to assess their condition and sometimes have tests and treatment such as renal dialysis.

Ophthalmology - patients with a disease of their eye, such as cataracts, glaucoma and retinal detachment, and who are likely to require surgery, or have recently had eye surgery, are seen by a ophthalmic specialist regarding their condition and treatment.

Orthopaedic - patients with a condition of the bones or skeletal system and who are likely to require surgery, or have recently had surgery, are seen by an orthopaedic specialist regarding their condition and treatment. It can include review of fractures and plastering, assessment for joint replacement surgery such as hip and knee replacements, sports injuries and trauma, carpal tunnel syndrome, bone tumours and amputations. Includes general, fractures, hand, and scoliosis orthopaedic clinics.

Pain Management - patients who suffer from chronic and persistent pain can attend this clinic to consult with a number of specialists depending on their condition and their needs. These usually include an anaesthetist, neurologist or a psychiatrist. Includes pain management and specialised persistent pain clinics.

Plastic and Reconstructive Surgery - patients who are likely to require surgery, or have recently had surgery, to restore, reconstruct, correct or improve the shape and appearance of structures damaged from injury or disease are seen by a specialist regarding their condition and treatment. Includes general plastic and reconstructive surgery and craniofacial clinics.

Respiratory - patients with diseases of their lungs, bronchial tubes, trachea, and the nerves and muscles needed for breathing are treated by a specialist in this clinic for conditions such as asthma. Includes general, asthma, chronic obstructive pulmonary, cystic fibrosis, sleep and thoracic respiratory clinics.

Rheumatology - a rheumatologist specialises in assessing, treating and rehabilitating patients who suffer from diseases of their joints, muscles and bones, such as arthritis.

Urology - a urologist cares for patients who have a disease or disorder of their urinary system such as incontinence, or require surgery such as prostate cancer surgery.

Vascular Surgery - a vascular surgeon reviews and manages patients with disease of their veins and arteries such as thrombotic disease and aneurysm, and consults regarding surgery such as angioplasties and access procedures for haemodialysis patients.

CATEGORIES

After receiving a valid referral from a GP, clinicians will give the patient a clinical urgency category depending on the urgency of their condition and place them on the outpatient waiting list. The category system ensures that all patients are seen in order of priority. There are three urgency categories, where 1 is most urgent and 3 is least urgent.

Category 1 - A condition that will require more complex or emergent care and will have significant impact on quality of life, if care is delayed. Patients should be seen within 30 days of being added to the waiting list.

Category 2 - A condition that has potential to require more complex care and to have some impact on the quality of life, if care delayed. Patients should be seen within 90 days of being added to the waiting list.

Category 3 - A condition unlikely to deteriorate quickly or to require more complex care, if assessment is delayed. Patients should be seen within 365 days of being added to the waiting list.

Total - This value shows performance for all categories of patients.

Patients waiting for an initial service event in a specialist outpatient clinic

How many people need a specialist outpatient appointment?
This data shows the number of patients on a specialist outpatient waiting list on a given day, listed in the heading. This is a measure of the demand for specialist outpatient services. The number of patients waiting in each specialty type shows the mix of patients.

Initial service events in a specialist outpatient clinic

How many new patients were seen in a specialist outpatient clinic?
An 'initial service event' is the first appointment a patient has with the health professional in an outpatient clinic, for treatment or management of the condition for which they have been referred. When a patient has had their initial service event, they are no longer on the waiting list for that service.

Non-surgical

Specialist outpatient clinics providing non-surgical care are clinics where the service provider is a health professional who usually manages the patient's condition with methods other than surgery. For example, oncology treatment for cancer.

Surgical

Surgical outpatient clinics are for patients requiring specialist surgical care. Surgical clinics include specialties such as Ear Nose and Throat, Ophthalmology, Orthopaedics as well as many other clinics. The GP and patient decide on the most appropriate medical clinic for referral dependent upon the patient's condition.

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As many as one in four patients don't show up for their appointment and fail to let the hospital know they're not coming. This means that appointment time cannot be offered to another patient and it can mean that other patients have to wait longer for their appointment than necessary.
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