Decreasing appointment waiting days for first consultation for patients attending adult weight management clinic in a tertiary hospital.

ABSTRACT

Adult weight management (AWM) clinic at our tertiary institution is a clinical service run for overweight or obese adult women, who are also under the care of gynaecologists for subfertility or menstrual irregularities. Unfortunately, the appointment waiting days for the first consultation at AWM clinic were long, which affected the timeliness of care given to our patients. We suspect that the referred patients are more likely to forget or lose motivation during the long waiting days, resulting in higher non-attendance rates.Baseline data confirmed that average of median appointment waiting days for the first consultation was 74 days. A multidisciplinary team of weight management clinic stakeholders was created to address this issue. Following a root cause analysis, the team implemented two interventions to improve appointment waiting days.The first intervention was offering video consultation to new cases for AWM clinic. This increased the clinic capacity without requiring additional physical clinic space. The referral criteria were refined to target patients who are most likely to benefit from the services provided at our institution. The second intervention was creating AWM clinic appointments only after patients completed the required laboratory investigations for obesity workup.A run chart demonstrated average of median appointment waiting days decreased from 74 days to 34 days after implementation of the second intervention (p=0.0104). The team successfully decreased and sustained the lower appointment waiting days through innovative interventions that increased clinic capacity and improved patient selection, with the potential to further increase clinic capacity if the demand surges.