Queen's University alternative funding plan. Effect on patients, staff, and faculty in the Department of Family Medicine.

OBJECTIVE To determine the effect of the Queen's University alternative funding plan (AFP) on the Department of Family Medicine in terms of patient, staff, and faculty satisfaction; patient encounter logistics; clinical volume; and academic activity.

DESIGN Before-after study.

SETTING Department of Family Medicine at Queen's University of Kingston, Ont.

PARTICIPANTS Patients, faculty, and staff of the Department of Family Medicine's Family Medicine Centre.

INTERVENTIONS The AFP of Queen's University.

MAIN OUTCOME MEASURES Patient satisfaction, staff and faculty job satisfaction, patient waiting time, time spent with patients, patient volume, number of publications, and amount of research funding obtained by faculty members. These outcomes were measured before the AFP began (time 0), 1 year post-AFP (time 1), and 2.5 years post-AFP (time 2).

RESULTS In some categories patients' satisfaction decreased at time 1, but in all cases it was either unchanged or improved at time 2. Staff and faculty job satisfaction did not change over time. Patients spent less time in the waiting room at time 2 than at time 0. Patient volume dropped about 10% between time 0 and time 2. Publication rate did not change, but external research funding increased significantly during the study period.

CONCLUSION The AFP has improved academic productivity, decreased patient volume by 10%, and improved patient flow during clinics. No negative effects on patient satisfaction or on job satisfaction of staff or faculty are apparent.