Facts and Opinions: Hospital Wait List Lessons From the UK
Notice bibliographique
Résumé
Hospital Wait ListLessons from the UK he issue of reducing waiting for health services in the UK has been a political initiative for the Blair government for several years.Interestingly, "reducing waiting for healthcare" was the key communication in Britain rather than reducing waiting times for "key procedures," which signalled that initiatives were to be put in place to reduce waits in the health system generally.As a result, this included, for example, waits to obtain service from general practitioners, as well as waits for hospital-based services.The wait for healthcare services was, in certain cases, horrendously long, averaging as much as 18 months or more for some in-hospital procedures in some areas of the UK.The public was outraged.Britain has a culture of trial-by-media with a result that there were daily reports on how bad the NHS was compared with other countries in Europe.The barriers to change were substantial; the UK system had not been through the years of reengineering and restructuring that many provinces in Canada have experienced.The result initially was shock, followed by the realization that hospitals did not know how to start to deal with the problems.This led to many false starts and embarrassing media reports.The government initially chose to take a strident shame-orblame approach, using a method that resulted in public exposure on a regular basis.Chief executives in hospitals that didn't conform were removed.Fear was the main motivation for change.The levels of resentment increased, and finally the government took a less aggressive approach.Fear only worked for a short time.Getting compliance internally was easier in the UK than it may be in Canada; many more physicians in the UK are on salary (or some other sessional payment scheme), and so conformance with a hospital-based wait list process was easier to implement in the UK than it may be in Canada.In addition, unlike in Canada, where physicians' secretaries are often the only people who know the extent of the wait, procedure, scheduling and the documentation of wait lists, in the UK, this information was already administered by the hospitals.Another issue facing hospitals in the UK was the extensive (some would say excessive!)governmental reporting requirements.The government initiated a "star" ranking system, which required hospitals to report annually on 140 key performance indicators.Based on the performance of the hospitals on these 140 indicators, the hospitals achieved zero-through three-star ratings.The results were made public.In addition, they were
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Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,008 | 0,052 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,004 | 0,004 |
| Communication savante | 0,008 | 0,009 |
| Science ouverte | 0,002 | 0,004 |
| Intégrité de la recherche | 0,014 | 0,021 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,017 | 0,003 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
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