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Enhancing management of hospital waiting lists through redesign and testing of validation letters

Case study | |

It is good practice for hospitals to check whether patients on waiting lists are still in need of treatment. This is commonly done via so-called validation letters to patients. Yet, it is estimated that approximately 25% of patients do not provide a response to the letters. In Ireland, BCI was used to redesign and test different letter formats to encourage more patients to engage with the validation process. Through an RCT, the study found that using the redesigned letter resulted in nearly 20 % of non-responders changing their behaviour and responding. The revised letter includes design elements such as a call for action, simplification, personalization, an apology for the waiting time, and highlighting consequences of non-response (such as removal from the waiting list). Following the publication of the results in 2018, the redesigned letter has been adopted as the national template for waiting list validation correspondence in Ireland (1).



  1. Murphy, R., Taaffe, C., Delaney, L., Lunn, P., Robertson, D., Ryan, H., & Wood, A. (2020). The Better Letter Initiative: An Impact Evaluation of a Redesigned Waiting List Validation Letter, Research Services and Policy Unit, Department of Health
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