Can a patient-focussed bookings approach reduce patient non-attendance in postnatal and continence physiotherapy?

BACKGROUND: There are unique life-stage and psychosocial barriers to attendance for women referred for postnatal and continence physiotherapy. These barriers affect access to care, clinic utilization and patient waiting lists. In a patient-focused bookings system, the patient is invited to contact the health service to book their appointment at a time and day that suits them, increasing patient choice and engagement in the booking process. METHODS: A patient-focussed bookings approach was implemented in outpatient women's health and continence physiotherapy clinics across four sites of a public health service in Australia. Waiting time, attendance, clinic utilization and response data were collected for 6 months after implementation to assess feasibility and effectiveness compared to the same 6 months of the preceding year. RESULTS: Non-attendance to initial appointments decreased from 23.64%, to 13.04%, with 26.2% more new patients seen and a 14.74% reduction in waiting times during implementation. Response rates did not appear to be affected by whether patients understood English and patients were satisfied with the new bookings approach. CONCLUSIONS: Patient-focused bookings can be effectively implemented in a postnatal and continence physiotherapy outpatient setting, resulting in reduced non-attendance and wait times and improved clinic utilization.

Micromachined Fused Silica Liquid Core Waveguide Capillary Flow Cell.

A planar, chip-based flow cell for UV-vis absorbance detection in HPLC is presented. The device features a microfabricated free-standing liquid core waveguide (LCW) capillary detection tube of long path length that is based on total internal reflection. We report on the linearity and calibration slope characteristics of lithographically produced LCWs with different interior/exterior geometries. 3D ray tracing was indispensable in modeling behavior in the more demanding geometries: multipath behavior may be intrinsic to these waveguides with consequent nonlinearity. Fortunately, nonlinearity in lithographically easy-to-produce waveguide geometries (such as with a flat, concave exterior and a round interior) is not as detrimental as might be initially expected. Experimental performance is predictably affected by the attainable surface quality of the LCW and efficient and reproducible coupling of the input light into the LCW.