| Sub-title | |
| Author | M K Tilney |
| Abstract | Problem: increasing waiting lists, inappropriate referrals and mismatched scheduling led to suboptimal clinic use. Better use of clinic resources was identified as a priority to improve patient care. At the time of initiation of this project, no systems existed for prioritization or analysis of referral data, or clinic throughput. Design: prospective review of referrals during 2004-6 in clinics at the interface of primary and secondary care. The aim was to identify causes of the problem, introduce changes and reassess regularly. Setting: Two MCC/Schedule V Clinics (Floriana/Gzira) prospectively collated referral data; observation of factors impinging on patient throughput. Key measures for improvement: waiting lists, inappropriate referrals, availability of patient notes, patient throughput and scheduling, monitoring of non-attenders. Strategies for change: monitoring of referrals for prioritization, vetting for inappropriate referrals, introduction of protocol, amendments to appointment letter with reminders re investigations, medication and documentation; availability of St Lukes Hospital notes for all patients; introduction of records for all patients, use of telephone follow-up, and one-stop appointments, management of non-attenders. Effects of change: reduction in waiting lists from over three months (Jan 2004) to four weeks (July 2006); early redirection of inappropriate referrals; improved patient scheduling and throughput; improved record keeping, reduction in non-attenders. Lessons learnt: appropriate proactive management strategies can result in more appropriate use of limited resources; further improvement will require interdepartmental and intercollegial collaboration,as well as improved support services. |
Published in: | |
| Journal | Malta Medical Journal |
| Volume | 15 Issue 1-2/suppl. 2003 |
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| Key words | clinic resources, inappropriate referrals, non attenders, protocol, scheduling, waiting lists |