Healthcare Workflow Interventions to Reduce Delays in Urological Care: A Systematic Review

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ID: 332065
2026
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Abstract
Abstract Background Delays in urological care can increase symptom burden, defer diagnosis and treatment, and reduce the efficiency of outpatient and surgical pathways. This review evaluated organisational interventions intended to improve patient flow and timely access to urological care. Methods PubMed/MEDLINE, Cochrane CENTRAL, Web of Science, and Lens.org were searched for English-language studies published from 1 January 2020 to 25 July 2026. Two reviewers independently screened records and appraised methodological and reporting quality. Because interventions, designs, and outcomes were heterogeneous, findings were synthesized narratively. Reference-list (citation) searching identified additional eligible primary studies. The four-source search was rerun on 25 July 2026 and all retrieved records were re-screened against the prespecified eligibility criteria. Results Twenty studies met the intervention eligibility criteria and were included in the synthesis; two further studies reporting patient experience without an implemented intervention are summarised separately as contextual evidence. Interventions were grouped into six domains: workforce redesign, fast-track pathways and service redesign, digital health and monitoring, surgical scheduling optimisation, waiting-list management, and system-level prioritisation. The largest reported improvements followed pathway redesign and active list management, including a decrease in urgent-referral waiting time from 59.0 to 21.6 days and a 76% reduction in patients waiting at least 12 months. Methodological and reporting quality scores ranged from 24 to 35 of 39 (mean 29.0); individual ratings and methodological concerns are provided in the supplementary material. Patient experience and long-term sustainability were infrequently measured. Several included studies were pandemic-specific, limiting direct generalisation to routine delivery. Conclusion Workflow interventions can reduce delays in urological care, particularly when they combine explicit triage rules, protected capacity, workforce redesign, and active queue management. However, heterogeneous designs, limited patient-reported outcomes, and short follow-up reduce certainty about comparative effectiveness and sustainability. PROSPERO registration: CRD420261377822
Reference Key
openalex_W7221361067 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Rafaela Mendonça, Marcello Perez Marques de Azevedo, Maria Cláudia Bicudo, João Paulo Zambon
Journal International journal for quality in health care : journal of the International Society for Quality in Health Care
Year 2026
DOI
10.1093/intqhc/mzag163
URL
https://doi.org/10.1093/intqhc/mzag163
Keywords Keywords not found

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