Although managing outpatient demand and capacity has always had its challenges, COVID-19 has added a new dimension to treating patients as outpatients. 

So, let’s take a look at some of the ways outpatient departments have already been impacted by the pandemic (good and bad), trends we’re noticing, and what we expect to happen in the coming months and years.

Positive Impacts

While it’s been a challenging couple of years, the pandemic hasn’t been all bad. 

For a start, the pandemic has accelerated solutions to some long-term technology problems that had been preventing broader scale telehealth initiatives. 

It has also boosted clinician and patient acceptance of online care and other alternative models of care.

The Australian Bureau of Statistics (ABS) released data on health service use during COVID-19 and found that:

28.8% of people had used telehealth in the previous 12 months
83.4% of those who had a telehealth consultation in 2020-21 would use it again if offered
40.1% of people with long-term health conditions were likely to use telehealth, compared to 16.5% of those without 

And a McKinsey analysis found that telehealth utilisation for office visits and outpatient care was 78 times higher in April 2020, compared to February 2020. And investments in digital health innovation were three times higher in 2020 than in 2017. 

Negative Impacts

Despite several positives, there’s no doubt that the pandemic has had greater negative impacts on public waitlists for outpatients.

Since the start of 2020, hospitals around the world have seen:

• Non-urgent appointments postponed during COVID ‘waves’ – In 2019-20, Australian hospitals saw 852,000 fewer non-admitted service events compared to 2018-19
• Increase in cancelled, postponed, and rescheduled appointments – Due to patients not wanting to risk exposure, as well as the lack of hospital capacity during waves or when capacity restrictions have been in place 
• A temporary drop in referrals – Compared with 2018-19, Australian hospitals saw public hospital waiting list new referrals or ‘additions to the waiting list’ decline by 6.2% (although large influxes are now occurring, with patients more freely accessing their GP or community care provider)
• Growing waitlists – In the UK, waitlists grew to 5.6 million in July 2021 (the longest the lists have been) and the situation is expected to get worse
• Reduced staff available to service clinics or provide online care – All clinical services (not just outpatients) have had reduced staff as a result of COVID-19 infections or being close contacts
• Changing workforce – In particular, outpatient teams that have typically relied on agency or temporary staff have been unable to access their usual ‘pool’ who have instead been utilised by or redeployed to testing clinics, injection clinics, and higher acuity areas

All clinical services have had reduced staff as a result of COVID-19 infections or being close contacts.

Current Trends in Public Hospitals

 Across all of our current SystemView sites, we have seen the following trends:

• Increasing total patients waiting
• Increasing numbers of long waits
• Decreased additions during COVID peaks, as well as decreased removals
• Significant cancellations/reschedules during COVID waves
• Increase in ‘no shows’ or patients who fail to attend their appointment 
• Significant increases in virtual care

Impacts on Hospital Staff

The impact that these variables have for patients is fairly obvious: an increased likelihood of a poorer health outcome. But the impact this will have on hospitals and staff is less clear. 

Here’s what we anticipate:

• Administration staff – Already, we’ve seen a huge increase in workload for administration staff because they’re putting new cases back onto waitlists, and doing additional waitlist reviews and audits. 
• Leaders – As the pressure to ‘recover waiting lists’ increases, executives and operational leaders will be tasked with sourcing alternate models for providing care to patients as well as keeping the community they support safe, informed, and content. 
• Clinicians – Clinical staff will no doubt feel the burden of high volume backlogs of patients waiting for care. They’ll likely treat sicker (and less patient) patients when they are able to see them and will almost certainly be asked to work after business hours and on weekends to try and get through the lists. 

As the pressure to ‘recover waiting lists’ increases, executives and operational leaders will be tasked with sourcing alternate models for providing care to patients.

 

How Can Hospitals Get Outpatient Waitlists Back On Target?

What is clear is that healthcare organisations and clinical teams are now faced with a huge task. They need to make up for reduced ‘scheduled care’ capacity during the COVID-19 peaks in order to get outpatient wait times back on target. 

It’s also clear that in order to reduce the backlog, hospitals will need to look beyond their existing approaches to waitlist management.

In order to reduce the backlog, hospitals will need to look beyond their routine approaches to waitlist management.

 

Read More About Outpatients

Want to learn more? Check out our in-depth guide on Outpatient Fundamentals to dive deeper into other issues facing outpatients, as well as strategies like alternative models of care, performance measures, chronological booking, and clinic effectiveness.