Waiting times mean different things in the healthcare sector. Surgical waiting time is an important issue in healthcare provision. It is considered to be excessive (longer than 90 days) in most countries that are members of the Organization for Economic Co-operation and Development (OECD) but small in the western and developed countries like the United Kingdom, the United States, and Canada. The difference in the surgical waiting time in developing and developed countries is attributed to the introduction of the concept of surgical waiting time initiative (SWAT) in the developed countries in a bid to reduce elective surgery waiting lists and increase the efficiency of care ( Abdulkareem, 2014) . In other terms, SWAT has been established in the developed countries but not in the evolving nations. The development of day surgery in outpatient clinics is one of the strategies that proved effective in reducing surgical waiting time. Recent research shows that nations with higher percentages of day surgery procedures have shorter surgical waiting times ( Caldinhas & Ferrinho, 2013) . This paper discusses that various strategies for reducing surgical waiting time.
As indicated earlier, increasing the popularity of day surgery is one of the strategies that do shorten not only elective waiting lists but also minimizes cancellations. Also referred to as outpatient surgery or ambulatory surgery, day surgery allows a patient to return home the same day that a surgical procedure is performed. In a bid to reduce surgical waiting times, more procedures are now being performed in a surgeon’s office rather than in an operating room. The reason attributed to the assertion that day surgery reduces surgical waiting times is that it eliminates inpatient hospital admission ( Caldinhas & Ferrinho, 2013) . The reduced inpatient hospital admission does not only reduce the amount of medication prescribed but also uses a doctor’s time more effectively.
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In the United States, more than half of the elective surgery procedures are performed as day surgeries. The day surgery technique has been developed for the past three decades due to various reasons which include but are not limited to improved surgical instruments, the desire to reduce healthcare costs, and less invasive surgical techniques. Furthermore, day surgery has developed as a result of a team approach in preparing a patient for surgery and home recovery that involves both an anesthesiologist and a surgeon ( Caldinhas & Ferrinho, 2013) . Notably, day surgery is only suitable for healthy people undergoing intermediate or minor procedures. As such, day surgery does not entail ophthalmologic, urologic, ear, throat, nose, and other procedures involving extremities.
Strategies for reducing waiting times are both supply-side and demand-side. An example of the supply-side techniques is increased hospital capacity and staff. Imbalances and shortages of workforce supply have the potential to affect waiting times. Therefore, planning mechanisms like improved scheduling of outpatient visits and preoperative assessment by nurses are useful in addressing work-force requirements ( Willcox et al., 2007) . England and Wales are examples of countries that have reduced surgical waiting times through improved scheduling of outpatient visits and preoperative assessment by nurses.
On the other hand, an example of the demand-side strategies is the use of explicit criteria to prioritize access to surgery. Countries like New Zealand and Canada use the clinical priority assessment criteria (CPAC) to reduce surgical waiting time. The CPAC gives priority to patients with the greatest need and ability to benefit ( Willcox et al., 2007) . Although CPAC has been associated with controversy, it has successfully reduced the waiting time for cataract operations, coronary artery bypass graft, hip and knee replacement, and general surgery.
Other ways of reducing patient wait times in surgery centers include shortening the turnover time, shortening the time before surgery, having good patient contacts, stagger scheduling, and keeping the patient informed. The turnover time should be reduced by 15 minutes. The patient arrival time before pre-op should be shortened from 2 hours to between 45 minutes and 60 minutes ( Howell, 2011) . The reason as to why many surgery centers require a two-hour lead time is that it allows them to schedule the patient earlier if an appointment falls through. However, this is rare in a well-managed surgery center. Regarding having good patient contacts, surgery centers should ask for three patient contacts, namely a patient’s telephone number, the telephone number of the patient’s spouse or friend, and patient’s email address. Stagger scheduling implies having block times that reflect and correspond with a surgeon’s pace ( Howell, 2011) . A faster surgeon should have shorter block times. Furthermore, surgical wait times can be minimized by keeping the patient informed of what is going on if the schedule starts to slow down.
In summary, reducing surgical wait times is crucial because it does shorten not only elective waiting lists but also minimizes cancellations. There are various methods of reducing waiting time before surgery. They range from day surgery to supply-side strategies like increased hospital capacity and staff and demand-side techniques like the use of explicit criteria to prioritize access to surgery. Other strategies for reducing waiting times in surgery centers before operation include shortening the turnover time, shortening the time before surgery, having good patient contacts, stagger scheduling, and keeping the patient informed.
References
Abdulkareem, I. H. (2014). The surgical waiting time initiative: A review of the Nigerian situation. Nigerian medical journal: journal of the Nigeria Medical Association , 55 (6), 443.
Caldinhas, P. M., & Ferrinho, P. (2013). Day-surgery and surgical waiting time. Revista Brasileira de Epidemiologia , 16 (2), 314-327.
Howell, G. (2011). 5 Ways to Reduce Patient Wait Times in Surgery Centers . Beckersasc.com . Retrieved 16 March 2018, from https://www.beckersasc.com/asc-turnarounds-ideas-to-improve-performance/5-ways-to-reduce-patient-wait-times-in-surgery-centers.html.
Willcox, S., Seddon, M., Dunn, S., Edwards, R. T., Pearse, J., & Tu, J. V. (2007). Measuring and reducing waiting times: a cross-national comparison of strategies. Health Affairs , 26 (4), 1078-1087.
