Evaluation of a Rapid Access Program in Rheumatology for Laval (PARLER)


To evaluate the capacity of a nurse led triage and rapid access program to reduce waiting time for a visit with a rheumatologist for patient with early rheumatoid arthritis or other acute inflammatory arthritis.

Conclusions and results

This program correctly identified the priority level for most patients and resulted in rapid consultation for those patients with a high priority. Available data are not sufficient to recommend implementing this program in the whole province. More information on the relative validity, effectiveness and efficiency of other approaches are requires.

Furthermore, due to the labor intensiveness of the program, feasibility issues need to be resolved before implementing this type of triage in a resource constrained healthcare system, especially regarding the impacts on health services organization and on costs.


No recommendations were formulated


A field evaluation of a nursed-led triage and rapid access program in rheumatology was conducted. In this program, a nurse assessed all new referrals received between 2009 and 2010, in a suburban Montreal rheumatology clinic. Priority level was assigned based on the written content of the referral, a telephone interview with the patient and, if needed, an partial joint examination. Patients with ERA, including undifferentiated inflammatory arthritis, and other acute rheumatologic conditions were prioritized and given an appointment as early as possible. Validity (sensibility and specificity) of the priority level for patients with ERA and delays from referral to first visit with rheumatologist were assessed based on primary data collected.

Further research/reviews required

Direct comparison of validity, effectiveness and efficiency of the approach used in this program with that of other triage tools and approaches currently used in rheumatology would require additional research.

Written by

Linda Pinsonneault, INESSS, Canada

INAHTA Brief issue: 2013/009

Agency: INESSS, Institut national d'excellence en santé et en services
View contact details

More about this report:
INAHTA Brief in pdf


ISSN : 1915S3104 INESSS (PDF)
ISBN 978S2S550S68658S3 (PDF)

" alt="http://www.inesss.qc.ca/fileadmin/doc/INESSS/Rapports/OrganisationsSoins/INESSS_Evaluation_PARLER.pdf">PARLER


Other publications:

Glossary, Acronyms & Publications:
HTA Glossary
List of acronyms
Publication type information