Patient Choice
Booking Project
Jacinta Opie
Project Manager
26th November 2013
Specialist Clinics Austin Health
• Specialist Clinics (formerly known as Outpatient
Department) is a consultative-based he...
Specialist Clinics Austin Health
• Specialist Clinics are located on;
– Level 3 Lance Townsend Building, Austin Hospital
–...
What is Patient Choice Booking
(PCB)?
• It is an appointment scheduling system and waiting list
which allows patients to b...
Background
• The partial booking (PB) outpatient appointment system
was introduced by the UK Department of Health in 1999....
Background
• The Royal Adelaide Hospital first introduced Partial Booking
(PB) for new appointments in 2006.
• Several Vic...
Why change booking systems?
• Patient Focused.
• Creates better access for patients.
• Department of Health have establish...
What are the benefits of PCB
• Better access to Specialist Clinics as we are not
booking appointments two years in advance...
Old booking system
• Future clinics booked 2 years in advance.
• Incorporates both new and review appointment types.
• Urg...
Old booking system
• Rescheduled patients are rebooked out of order as future
clinics are fully booked.
• Patient had no c...
New booking system
• Future appointments are booked only 4 weeks in
advance.
• Incorporates both new and review appointmen...
New booking system
• Separate waiting list for new and review appointments.
• The waiting list is used to control and even...
New Patient work flow
Central
referrals
Referral
registered
placed on WL

Sent to unit for
triage

Urgent 1-4
weeks

Appoi...
Implementation of PCB
• Before implementation of PCB
– Development of software/hardware
– Personnel
– Training/education –...
Implementation of PCB
• Phase one: 500 clinics managed by Specialist Clinics
• 49,000 future appointments were cancelled a...
Results
Results
Results
ENT – Activity
ENT - Activity
ENT - Activity
Outpatients to Elective Surgery
• Improved access to outpatients has had a flow on effect to
the elective surgery waiting ...
Where to from here?
• Fix software issues with PCB
• Implement online training module
• Monitor activity
• Formal evaluati...
Thank – You
Any Questions?
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Jacinta Opie, Austin Health: Patient Choice Booking at Austin Health

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Jacinta Opie, Project Manager – Patient Choice Booking Project, Austin Health delivered this presentation at the 2013 Elective Surgery Redesign Conference. The National Conference focussed solely on assisting Australian Hospitals to meet the National Elective Surgery Target, including:
Streamlining Surgical Pathways
Improving Access & Patient Experience
Reducing Waiting Times
Incorporating Latest Technological Innovations
For more information on the annual event, please visit the conference website: http://www.healthcareconferences.com.au/electivesurgery

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Jacinta Opie, Austin Health: Patient Choice Booking at Austin Health

  1. 1. Patient Choice Booking Project Jacinta Opie Project Manager 26th November 2013
  2. 2. Specialist Clinics Austin Health • Specialist Clinics (formerly known as Outpatient Department) is a consultative-based health service, incorporating teaching, training, research and minor procedures for clients from the community and non-bed based hospital patients. • 221,645 patients attended Specialist Clinics in 2012 • The department is located across two campuses – Heidelberg Repatriation Hospital – Austin Hospital (4 sites, 5th site opening January 2014)
  3. 3. Specialist Clinics Austin Health • Specialist Clinics are located on; – Level 3 Lance Townsend Building, Austin Hospital – Level 3 Olivia Newton-John Cancer & Wellness Centre (ONJCWC), Austin Hospital – Ground Floor,Tobruk Building, Heidelberg Repatriation Hospital – Level 2, Centaur Building, Heidelberg Repatriation Hospital – Level 4, Centaur Building, Heidelberg Repatriation Hospital (opening January 2014)
  4. 4. What is Patient Choice Booking (PCB)? • It is an appointment scheduling system and waiting list which allows patients to be treated in turn and in the time frame required. “A better way for outpatient appointments”
  5. 5. Background • The partial booking (PB) outpatient appointment system was introduced by the UK Department of Health in 1999. • NHS targeted outpatient appointment waiting times of over 13 weeks. • With PB, patients have the opportunity to choose a convenient outpatient appointment date. Failure to do so results in automatic removal from the PB system, with no appointment issued. Wong S.C., Chang L. & Lee N. 2003 , Partial booking is it flawed?, Quality in Primary Care, Vol. 11 No 2, pp 117-122(6)
  6. 6. Background • The Royal Adelaide Hospital first introduced Partial Booking (PB) for new appointments in 2006. • Several Victorian hospitals have introduced PB for new appointment types. • Austin Health completed project scoping in June 2010 & February 2011 application was approved 2012. • Patient Choice Booking project commenced November 2012 incorporating new and review appointment types.
  7. 7. Why change booking systems? • Patient Focused. • Creates better access for patients. • Department of Health have established a new Access Policy to Specialist Clinics. • New Key performance indicators (KPI’s) Austin Health are required to meet. • We needed a better system.
  8. 8. What are the benefits of PCB • Better access to Specialist Clinics as we are not booking appointments two years in advance. • Patients treated in turn. • Establish waiting list to even out demand. • Reduce patient overbooking's to the clinics. • Reduce patients that fail to arrive for an appointment. • Reduce “re-do” work by clerical staff. • Gives patients a choice about their appointments.
  9. 9. Old booking system • Future clinics booked 2 years in advance. • Incorporates both new and review appointment types. • Urgent patients must be overbooked into clinics as slots are filled ahead of time with non urgent patients. • Frequent rescheduling of appointments to try and control numbers. • Poor clinician leave notification resulting in rescheduling of appointments.
  10. 10. Old booking system • Rescheduled patients are rebooked out of order as future clinics are fully booked. • Patient had no choice in the appointment date or time just sent an appointment, resulting in rescheduling of appointments. • High rate of patients that failed to arrive for an appointment due to being booked so far in advance. • Patient flow varied with demand • Communication with GP on receipt of referral.
  11. 11. New booking system • Future appointments are booked only 4 weeks in advance. • Incorporates both new and review appointment types. • All urgent patients are booked as requested through the use of quarantine slots. • Patients are sent an offer letter when an appointment is available. • Patient telephone the Specialist Clinics call centre to make the appointment. Choosing a date and time that suits them.
  12. 12. New booking system • Separate waiting list for new and review appointments. • The waiting list is used to control and even flow reducing queuing • Offer of appointments are withheld if clinics are heavily booked • Non urgent patients are booked according to how long they have been on the waiting list. • Poor clinician leave notification resulting in rescheduling of appointments. • Patients no longer requiring their appointment usually do not respond to offer letters. • Improved communication with GP’s.
  13. 13. New Patient work flow Central referrals Referral registered placed on WL Sent to unit for triage Urgent 1-4 weeks Appointment made Outcome entered on WL Routine treat in turn Placed on WL treat in turn
  14. 14. Implementation of PCB • Before implementation of PCB – Development of software/hardware – Personnel – Training/education – developed online training module – Infrastructure changes to Specialist Clinics – Post implementation review • PCB Went live 6th May 2013. • The first impact of PCB was seen in June 2013.
  15. 15. Implementation of PCB • Phase one: 500 clinics managed by Specialist Clinics • 49,000 future appointments were cancelled and converted to PCB. • A letter was sent to all these patients informing them of new booking system. • Patient were also contacted by phone informing them their future appointment was cancelled. • A PCB hotline was established. • Increased staffing to the call centre.
  16. 16. Results
  17. 17. Results
  18. 18. Results
  19. 19. ENT – Activity
  20. 20. ENT - Activity
  21. 21. ENT - Activity
  22. 22. Outpatients to Elective Surgery • Improved access to outpatients has had a flow on effect to the elective surgery waiting list. • Data is available to drive change and improve access to Specialist Clinics. • Ability to target units to change clinic templates to improve service. • Allows better access to patients. • Reduced waiting times for initial assessment. • Patients placed on elective surgery waiting list faster.
  23. 23. Where to from here? • Fix software issues with PCB • Implement online training module • Monitor activity • Formal evaluation of PCB will occur early 2014 • Implement phase two of project to incorporate satellite clinics and allied health clinics. (approx. 1000 clinics) • Continue to drive change to allow patients better access to the outpatient department.
  24. 24. Thank – You Any Questions?

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