A systematic review of patient prioritization tools in non-emergency healthcare services
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RESEARCH
Open Access
A systematic review of patient prioritization tools in non-emergency healthcare services Julien Déry1,2, Angel Ruiz2,3,4, François Routhier1,2, Valérie Bélanger4,5, André Côté3,6,7, Daoud Ait-Kadi2,4,8, Marie-Pierre Gagnon6,9, Simon Deslauriers1,2, Ana Tereza Lopes Pecora2, Eduardo Redondo3,4, Anne-Sophie Allaire2 and Marie-Eve Lamontagne1,2*
Abstract Background: Patient prioritization is a strategy used to manage access to healthcare services. Patient prioritization tools (PPT) contribute to supporting the prioritization decision process, and to its transparency and fairness. Patient prioritization tools can take various forms and are highly dependent on the particular context of application. Consequently, the sets of criteria change from one context to another, especially when used in non-emergency settings. This paper systematically synthesizes and analyzes the published evidence concerning the development and challenges related to the validation and implementation of PPTs in non-emergency settings. Methods: We conducted a systematic mixed studies review. We searched evidence in five databases to select articles based on eligibility criteria, and information of included articles was extracted using an extraction grid. The methodological quality of the studies was assessed by using the Mixed Methods Appraisal Tool. The article selection process, data extraction, and quality appraisal were performed by at least two reviewers independently. Results: We included 48 studies listing 34 different patient prioritization tools. Most of them are designed for managing access to elective surgeries in hospital settings. Two-thirds of the tools were investigated based on reliability or validity. Inconclusive results were found regarding the impact of PPTs on patient waiting times. Advantages associated with PPT use were found mostly in relationship to acceptability of the tools by clinicians and increased transparency and equity for patients. Conclusions: This review describes the development and validation processes of PPTs used in non-urgent healthcare settings. Despite the large number of PPTs studied, implementation into clinical practice seems to be an open challenge. Based on the findings of this review, recommendations are proposed to develop, validate, and implement such tools in clinical settings. Systematic review registration: PROSPERO CRD42018107205 Keywords: Patient prioritization, Systematic review, Healthcare services, Waiting lists, Outcomes
* Correspondence: [email protected] 1 Department of Rehabilitation, Université Laval, Québec, Canada 2 Centre interdisciplinaire de recherche en réadaptation et intégration sociale (CIRRIS), Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, Canada Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distributi
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