Exploration into the behaviour of cardiac waiting lists

Abstract

This study explores the behaviour of cardiac waiting lists as they are of political and public concern. It investigates what dynamics are present between the different waiting lists run within a cardiac department. It also looks at how waiting lists interact across the medical/surgical boundary. In addition the thesis examines whether doctors are in control of waiting lists and what factors might affect any decision they make regarding their waiting lists.

A System Dynamics model is presented focusing on the effect of resource provisions on waiting list length in a Cardiac Surgery department. Qualitative data are then collected through the use of open ended questionnaires and interviews of relevant hospital personnel. The information gathered relates to doctors attitudes to and opinions on waiting lists. It is incorporated into a second System Dynamics model which spans both the Cardiology department and the Surgery department.

The findings reveal that decisions made in one department, designed to improve a waiting list, can have an adverse effect on another. It is also shown that doctors do control the dynamics of waiting lists though this is due to their clinical decision making being compromised through the insufficient provision of resources. Many factors are identified which affect waiting lists and clinical decision making.

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