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Staff perspectives of a model of access and triage for reducing waiting time in ambulatory services: a qualitative study

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posted on 2022-01-11, 04:35 authored by Katherine HardingKatherine Harding, David SnowdonDavid Snowdon, Annie LewisAnnie Lewis, Sandra LeggatSandra Leggat, Bridie Kent, Jennifer J Watts, Nicholas TaylorNicholas Taylor
Background: Specific Timely Appointments for Triage (STAT) is an intervention designed to reduce waiting time in community outpatient health services, shown to be effective in a large stepped wedge cluster randomised controlled trial. STAT combines initial strategies to reduce existing wait lists with creation of a specific number of protected appointments for new patients based on demand. It offers an alternative to the more traditional methods of demand management for these services using waiting lists with triage systems. This study aimed to explore perceptions of clinicians and administrative staff involved in implementing the model. Method: Semi-structured interviews with 20 staff members who experienced the change to STAT were conducted by an independent interviewer. All eight sites involved in the original trial and all professional disciplines were represented in the sample. Data were coded and analysed thematically. Results: Participants agreed that shorter waiting time for patients was the main advantage of the STAT model, and that ongoing management of caseloads was challenging. However, there was variation in the overall weight placed on these factors, and therefore the participants' preference for the new or previous model of care. Perceptions of whether the advantages outweighed the disadvantages were influenced by five sub-themes: staff perception of how much waiting matters to the patient, prior exposure to the management of waiting list, caseload complexity, approach and attitude to the implementation of STAT and organisational factors. Conclusions: The STAT model has clear benefits but also presents challenges for staff members. The findings of this study suggest that careful preparation and management of change and active planning for known fluctuations in supply and demand are likely to help to mitigate sources of stress and improve the likelihood of successful implementation of the STAT model for improving waiting times for patients referred to community outpatient services.


This trial was funded by the National Health and Medical Research Council (NHMRC) of Australia with a 'Partnerships for Better Health' Grant (APP 1076777), with contributions from industry partners Eastern Health (in-kind) and the Victorian Department of Health and Human Services (DHHS) (direct and in-kind).


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BMC Health Services Research



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Springer Nature



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© The Author(s). 2019 This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

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