Failures in hospital appointment centers

Waiting long minutes (or even hours) on the phone to make an appointment with a medical specialist, having to call back later because the time slots are reserved or not yet displayed, being unable to cancel a consultation… Appointment centers You Quebec hospitals are experiencing many failures and patients are paying the price, reports the Association of Specialists in Internal Medicine of Quebec (ASMIQ).

The group is conducting a survey of its members to find out what they “need to treat their patients”. About 350 internal medicine specialists out of the 700 who practice in Quebec have answered the questionnaire so far. The “vast majority” indicated – in an open question, and not with a choice of answers – that the operation of the central appointments of their hospital should be improved, reports the president of the ASMIQ, the D^r Hoang Duong.

“That members see so many problems in so many appointment centers surprised us,” says Dr.^r Duong. He specifies that the participants in the survey, who work in some twenty hospitals across Quebec, consider this issue a priority, as does the lack of nurses and staff. Remember that in addition to treating hospitalized patients, internal medicine specialists see patients in outpatient clinics (ambulatory mode).

Among the doctors surveyed, many deplore the absence of a reminder 24 hours or 48 hours before an appointment, which contributes to the famous ” no shows ”, according to the D^r Duong. “If you make an appointment with your dentist, we do a reminder. You make a reservation at the restaurant, we confirm the day before, ”he says. Such a procedure should be implemented in all hospitals, he said, to prevent time slots from being lost. He also says he understands that patients forget their consultation, especially if they have several to manage.

The D^r Pierre McCabe, specialist in internal medicine at the Anna-Laberge hospital in Châteauguay, describes as “archaic” the system for making appointments in hospitals like his. “It can take hours to get the line [téléphonique] because it lacks resources [humaines] he says.

He does not understand why new technologies similar to Clic Santé and Rendez-vous santé Québec (RVSQ) are not implemented in hospitals in the province. “Why do we have this on the front line, why do we have this to make an appointment for our blood tests, our vaccines, and why are we not able to do this for the hospital systems? he asks himself.

The CISSS de la Montérégie-Ouest recognizes that “due to the lack of staff”, its appointment center is facing “certain challenges”. “We are well aware of the inconvenience caused and that is why we are working on all fronts to make the positions more attractive and to promote recruitment,” we wrote in an email.

Staff shortages are also a problem in other hospitals, according to the sources consulted.

A new system at Sacré-Coeur

For the past few months, the CIUSSS du Nord-de-l’Île-de-Montréal has set up a one-stop service for making appointments with specialists. Doctors send consultation requests directly to the centre, which is responsible for offering appointments to patients according to their “clinical priority”.

According to the D^D Michelle Goulet, head of the internal medicine department at the Sacré-Coeur-de-Montréal hospital, its implementation is difficult. “Very many appointment slots have remained unused since November, and doctors are literally twiddling their thumbs in the clinic. This is unacceptable given the waiting times to see a medical specialist,” she says.

The D^D Goulet estimates that the rate of patient absenteeism has almost doubled since the arrival of the counter. “Patients regularly tell us that they didn’t get a call or that they got a last-minute message on their voicemail and they listened to it too late,” she explains. She deplores the lack of flexibility of this centre, which cannot quickly add appointments when a doctor discovers new availability.

According to ASMIQ, internists practicing elsewhere in Quebec also complain about the delays in adding appointments to their agenda.

Asked about its new counter, the CIUSSS du Nord-de-l’Île-de-Montréal says that it ensures “better management of supply and demand and allows for a global vision”. The establishment points out that “a 25% reduction in the number of out-of-time appointments has been recorded” in internal medicine since its implementation in November. He invites doctors to share their “concerns” with him.

An irritant for specialists, according to the FMSQ

The dysfunction of hospital appointment centers also irritates doctors in other specialties, according to the Federation of Medical Specialists of Quebec.

“Our systems are outdated. We are really in the prehistory of telephony, ”says its vice-president, the D^r Serge Legault. However, hospitals are adopting “a little more proactive telephone systems, where there are telephone reminders by text or voice”, he specifies.

The D^r Duong hopes that changes will be made in all of the appointment centers of Quebec hospitals. “The network would see improved access [aux services], does he think. Physicians could see more patients in more sensible, more relevant timeframes. And the customer experience, as Minister Dubé calls it, would be improved. »

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