Improving the reliability of attendance at outpatient appointments: A successful partnership approach

摘要

Introduction : Queensland Hospital & Health Services (HHS) are facing significant challenges to ensure that all patients are seen within clinically recommended timeframes for outpatient appointments whilst not adversely affecting other targets (such as elective surgery waitlists). To ensure no appointment is wasted, a professional patient-centric confirmations model was trialed, measured, implemented and maintained. Aim : To reduce the number of wasted appointments, increase resource utilisation & uplift hospital funding. The target population for this intervention was children scheduled for an outpatient appointments from March 2016. Intervention : Children’s Health Queensland partnered with the Health Contact Centre (HCC) to develop an outpatient confirmation model. Patients are contacted by HCC 2 weeks prior to an appointment via a variety of contact sub-models (SMS, phone and acute care) to confirm the parent’s intent to attend. Information is relayed in a timely manner back to CHQ staff to action and ensure that any vacated appointments are filled with another patient. Results : Specialty median FTA rates were tracked prior and after implementation. Weekly analysis of results was undertaken with statistical process control charts. After implementing the confirmations partnership strategy, paediatric specialist outpatient services now has a median new patient FTA rate of 6.16% and review rate of 6.49% (50% reduction) and have become more efficient by about 10,000 patients per year. The waitlist now has only 250 patients waiting longer than clinically recommended (reduction of approximately 5,300 patients) and evidence-based KPI's for FTA have now been established for Queensland. Sustainability & expansion : This model is now embedded into CHQ and funding has been received to trial the HCC confirmations model in an adult facility to seek replication and expansion across the state. Two HHS’s have been selected for this expansion by the Queensland Healthcare Improvement Unit.