Wait watchers: the application of a waiting list active management program in ambulatory care

Objective: This study describes and evaluates the application of a waiting list management program in ambulatory care. Design: Waiting list active management survey (telephone call and further contact); before and after controlled trial. Setting: Local Health Trust in Veneto Region (North-East of Italy) in 2008–09. Participants: Five hundred and one people on a 554 waiting list for C Class ambulatory care diagnostic and/or clinical investigations (electrocardiography plus cardiology ambulatory consultation, eye ambulatory consultation, carotid vessels Eco-color-Doppler, legs Eco-color-Doppler or colonoscopy, respectively). Intervention: Active list management program consisting of a telephonic interview on 21 items to evaluate socioeconomic features, self-perceived health status, social support, referral physician, accessibility and patients' satisfaction. A controlled before-and-after study was performed to evaluate anonymously the overall impact on patients' self-perceived quality of care. Main outcome measures: The rate of patients with deteriorating healthcare conditions; rate of dropout; interviewed degree of satisfaction about the initiative; overall impact on citizens' perceived quality of care. Results: 95.4% patients evaluated the initiative as useful. After the intervention, patients more likely to have been targeted with the program showed a statistically significant increase in self-reported quality of care. Conclusions: Positive impact of the program on some dimensions of ambulatory care quality (health status, satisfaction, willingness to remain in the queue), thus confirming the outstanding value of ‘not to leave people alone’ and ‘not to leave them feeling themselves alone’ in healthcare delivery.