Evaluating Wait Time Management Strategies for Canadian Physiotherapy Services: A Scoping Review

Abstract

Background: Wait times for publicly-funded physiotherapy (PT) services in  Canada — such as those for outpatients recovering from surgery or children with disabilities — are high, which may force people to pay for care or face deteriorating quality of life. Specific waitlist management strategies are needed to address this problem, but there is no review on the subject in Cochrane and much of the current research focuses on reducing wait times in emergency rooms or surgery departments. PT is a different context with more flexibility in appointment structure (ie. length of time or number of patients) and thus more possible strategies to reduce wait times. This scoping review aims to identify which of those have already been studied in the Canadian context. 

Methods: This review was conducted using Arksey and O’Malley’s 2005 framework. EMBASE, Medline, CINAHL, SportDiscus, Canada Commons and Canada Research Index were searched for articles which evaluated wait time management strategies (WTMS) specific for PT services in Canada. A gray literature search of all the PT association and college websites across Canada was also conducted. 

Results: The eleven studies meeting inclusion criteria were conducted across Canada and evaluated diverse strategies through a range of outcomes. The most frequent were structural/organizational outcomes, but wait times and feedback from professionals were also common. Most often, strategies involved changing how PT services were delivered. 

Discussion: Further research needs to be done as very few studies were found meeting inclusion criteria. Included studies did not consistently report the context, population, or outcome measurement in enough detail for stakeholders in healthcare to examine the clinical applicability or for future researchers to compare the effectiveness of interventions. No results from the gray literature search were included, suggesting that WTMS for PT are not an area of focus for PT associations and colleges in Canada.  

Conclusions: There is a need for further evaluation of wait time management strategies in the unique context of PT, with improved reporting to make evidence-based practice feasible. We suggest that stakeholder groups in healthcare should consider wait time management for PT a higher priority and encourage further research.