Improving Occupational Therapy (OT) waiting times
Implementation of a telephone triage system (OTTTrS)
J Harkess, C Mitche...
Poster presentation   implemetation of telephone traige system - janet harkness
Poster presentation   implemetation of telephone traige system - janet harkness
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Poster presentation implemetation of telephone traige system - janet harkness

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Poster presentation implemetation of telephone traige system - janet harkness

  1. 1. Improving Occupational Therapy (OT) waiting times Implementation of a telephone triage system (OTTTrS) J Harkess, C Mitchell, F Tweedie, J Gibson, Fife Rheumatic Diseases Unit. BACKGROUND • Annual increases in referrals to FRDU OT including a 20% increase in referrals in 2007- 2008. • Long waiting times experienced by patients (at an average of 11 weeks for routine pa- tients 2006-2008). • Early aggressive therapy in Fife - some patients fully independent and did not want/need OT. - more patients able to work and resume leisure activites but need support to do this . - proportionate increase in non complex cases. Plan Do Study Act (PDSA) PLAN:Method Review of services with staff : • Waiting times - we antici- pated an increase in waiting times due to the ongoing increase in OT referrals • Capacity & capability - need to manage current and future service provision in light of national demographic trends - both an ageing workforce and general population. • Need to continue to be responsive - continue change of OT focus from just ADL to include more vocational & leisure rehabilitation, and, other health promotion activities. ACT: Conclusion Following implementation of the telephone triage system there was a: • 40% decrease in routine waiting times. • 68% reduction in the numbers of patients on waiting list • 23% increase in service capacity (equivalent to employing a 0.6 wte OT). 2 3 % i nc r e a se i n se r v i c e c a pa c i t y 0 500 1000 1500 2006-2008 2008-2010 pr e/ post t el ephone t r i age & extr a ski l l mi x number s r ef er r als(mean) new attendances(mean) r eview attendances(mean) total attendances 4 0 % de c r e a se i n me a n r out i ne wa it i ng t ime s 0 10 20 2006-2008 2008-2010 p/ post T T & ext r a ski l l mi x weeks waitingtimes- ur gents (mean) waitingtime- r outines (mean) DO: Primary Intervention We implemented a telephone triage system (OTTTrS) • To help screen out people not wanting/needing OT • To determine the nature of any functional problem(s), and, the best staff member and course of action for that patient. Secondary Intervention • We recruited an additional Rehabilitation Assistant (12hrs) to assist with the increase in less complex cases. Telephone Triage System (OTTTrS) PDSA Cycle Patient sent telephone appointment (if not appropriate, home visit arranged) OT initial telephone interview to establish if occupational performance problems through OT screening interview If problem(s) If no problems OT telephone advice OT home /work visit to further assess and/ or intervene. Rehabilitation assistant input for non complex interventions Telephone re- view in 3 months when stable on medication/ dis- charge if patient does not want/ need OT STUDY: Results One hundred and ninety eight (55%) patients were selected for a telephone 1st contact instead of a visit. Routine waiting times decreased by 40% from 11 wks to 6.5 wks. The number of patients waiting decreased by 68% from 82 to 26. The additional Reha- bilitation Assistant allowed for increased direct delegation to this staff group for less complex interventions. Overall service capacity increased by 23% allowing more new patients to be seen, and, vocational and leisure rehabilitation to be developed . Limitation No data was collated on where ‘no OT required’ or how many were triaged directly to the Rehabilitation Assistant. This data needs to be captured in the future. pa t i e nt s wa i t i ng 0 20 40 60 80 100 2006-2007 2007-2008 2008-2009 2009-2010 year number of pat i ent s number s waiting Tot a l ne w a ppoi nt me nt s- v i si t s:t e l e phone 2 0 10 198, 55% 161, 45% telephone visits Ref er rals 0 2 0 0 4 0 0 6 0 0 2 0 0 5 - 2 0 0 6 2 0 0 6 - 2 0 0 7 2 0 0 7 - 2 0 0 8 Ref err als

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