Delivering Person-Centric, Seamless Care through the Patient Appointment Consolidation (PAC) Programme

AimsThe aim of this audit is to explore the possible causes of clinic cancellation in an inner city CMHT and the recommendation to reduce the burden.BackgroundCancellations of planned appointments have been a major and long-standing problem for healthcare organisations across the world. It represents a significant loss of revenue and waste of resources, have significant psychological, social and financial implications for patients and their families and represent a significant loss of training opportunities for trainees. Re-scheduling appointment is one of the major issues of inconvenience to the patients. It also increases workload for the patient appointment team.MethodData have been collected retrospectively from patient appointment booking team regarding clinic cancellation with causes of cancellation recorded in the system (01/07/2019–30/09/2019). The investigators have investigated if the cancellation has been made when it was absolutely necessary to cancel the clinic (Unavailability of doctors due to leave/on calls) and if patients have been informed at least 8 weeks prior to the appointed clinic as per trust protocol.ResultTotal number of 193 clinics were booked at the CMHT from July 2019 – September 2019. About 54% clinics were cancelled during the time period. The Clinic Cancellation rate was higher in September (68%) and was lowest in August (30.30%). As the month of July is the changeover period for trainees, the number of clinics booked during August was relatively less than normal. 72% clinics were cancelled by junior doctors and 28% clinics were cancelled by consultants at the CMHT. The major cause of clinic cancellation was unavailability of the junior doctors due to on call (31.58%) which was not communicated to the patient appointment booking team. Due to annual leave, 25% clinics were cancelled and 21% clinics were cancelled due to study leave. In both cases it is evident that, lack of communication between clinicians and patient appointment team are primarily responsible for hospital-initiated clinic cancellations. As per Patient Appointment booking team, around 50% cases, patients were informed 8 weeks in advance before cancelling the clinics.ConclusionThis is evident from this audit that the number of hospital-initiated clinic cancellations can be reduced by improving communication between Patient Appointment booking service, Medical staffing department and clinicians. The findings of the audit have been shared locally with CMHT managers, clinicians and with the patient appointment booking team.

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GM-020 Seamless care: Development of a discharge communication tool for elderly patients

European Journal of Hospital Pharmacy ◽

10.1136/ejhpharm-2016-000875.376 ◽

2016 ◽

Vol 23 (Suppl 1) ◽

pp. A167.1-A167

Author(s):

J Giraud ◽

M Thevenet ◽

R Haddad ◽

S Leveque ◽

M Mion ◽

...

Keyword(s):

Elderly Patients ◽

Communication Tool ◽

Seamless Care ◽

Discharge Communication ◽

Care Development

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Telephone Follow-Up following Office Anorectal Surgery

Annals of The Royal College of Surgeons of England ◽

10.1308/003588408x300975 ◽

2008 ◽

Vol 90 (6) ◽

pp. 464-466 ◽

Cited By ~ 5

Author(s):

Rebecca C Fallaize ◽

Christine Tinline-Purvis ◽

Anthony R Dixon ◽

Anne-Marie Pullyblank

Keyword(s):

Patient Satisfaction ◽

Medical Treatment ◽

Patient Treatment ◽

Second Line ◽

Anorectal Surgery ◽

Fissure In Ano ◽

Level Of Satisfaction ◽

Patient Appointment ◽

High Level

INTRODUCTION Patients with minor anorectal conditions are frequently reviewed at an 8-week out-patient appointment (OPA). This study was designed to assess whether telephone follow-up could reduce OPA numbers whilst maintaining patient satisfaction. PATIENTS AND METHODS Over an 11-month period, 46 patients (23 male) underwent banding of haemorrhoids and 14 were prescribed medical treatment for fissure-in-ano (3 male). All were telephoned at 6 weeks and were offered an 8-week OPA if they had continuing problems. Patients were telephoned at a later date by a member of the hospital's patient panel to assess satisfaction. RESULTS Overall, 88% were contacted at 6 weeks, 60% at the first attempt; 40% required two or more attempts. Of those who underwent banding, 68% were asymptomatic, 17% requested an OPA for re-banding and 15% requested an OPA for a different problem. Of fissure patients, 25% were cured; the remainder were prescribed either second-line medical treatment (8%), anorectal physiology (42%) or surgery (25%). All avoided an OPA. Of a potential 60 OPAs, 47 were saved by telephone follow-up. None of 7 non-contactable patients accepted a written offer of an OPA. Overall, 89% of patients were contacted by the patient panel; of these patients, 93% reported a high level of satisfaction. CONCLUSIONS Telephone follow-up can reduce the number of OPAs following out-patient treatment of minor anorectal conditions whilst maintaining a high level of patient satisfaction. However, it requires considerable consultant time. This process could be developed into either a nurse-led service with booked telephone appointments or a patient-led service to a dedicated hotline.

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Health Systems and Home-Based Care: Closing the Loop

Hospital Pharmacy ◽

10.1310/hpj4410-915 ◽

2009 ◽

Vol 44 (10) ◽

pp. 915-916

Author(s):

Bill G. Felkey ◽

Brent I. Fox

Keyword(s):

Health Systems ◽

Care Setting ◽

Situational Awareness ◽

Digital Information ◽

Care Provision ◽

Seamless Care ◽

Home Based ◽

Closing The Loop ◽

Definition Of ◽

Home Based Care

In a previous article, we described that progressive health systems have begun to redefine the definition of their enterprise to include the most intensive acute care setting all the way to an individual patient's home. This is being made possible by the transformation into a digital field that all of health care is beginning to make a reality. The vision is seamless care provision, where digital information convergence produces new levels of continuity of care, efficiency, effectiveness, and total situational awareness. In this installment, we focus on the current potential for home-based care, without which the vision of seamless care will ultimately fall short.

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