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How can we ensure most ophthalmology patients are seen close to their…
How can we ensure most ophthalmology patients are seen close to their homes?
What do we want to achieve?
Balanced use of MHTC, Dumfries and GCH, Stranraer Ophthalmology according to patient home addresses
How can we do it?
By provision of equipment and trained staff in the West we can move appointments to GCH and address the balance
Approach
Examine current situation (triage MHTC list of patients who came from the West)
Vision for future - numbers and percentages and types of clinics
Outcome of triage
Remaining the same
Still have to come to MHTC 71 = 7%,
Intravitreal injections
Botox
Laser
Orthoptic
Joint rheumatology clinic
Urgent
Patients Choice- GCH or MHTCSurgery 47 = 4.5%
Cataract
Eyelid
Others
Change opportunities
291 = 28.2% Nurse led OCT clinics GCH
Phase 1 Friday am,pm
Phase 2 + Wednesday am, pm
192 = 18.6% Consultant led clinic, GCH
CHALLENGE - Capacity
Currently see 18 patients on one day per week
Capacity planning in GCH: Triage
Currently GCH Cons led clinics 667 patients (882 appointments) in 2017
Need to move 192 appointments = 21.7% from Cons led to nurse led clinics
Discharge, deceased (no further appointment necessary) 429 = 41%
Triage process map development
Process to ensure staff triage to the new standard
Challenge - capacity of
consultant led clinics in GCH
Triage GCH patients (from West)
Opportunity to transfer patients from Consultant clinis into nurse led OCT clinics
Triage process map development
Enabling
Training of GCH nurses
Changes to bookings system
Provision of OCT machine in GCH
Measures
Quantitative
GCH
Total number of eye patients seen in consultant led clinics in GCH weekly (o)
DNA rate in GCH weekly (p)
Total number of eye patients seen in nurse led OCT clinics in GCH weekly (o)
Total number of eye patients seen in GCH weekly (o)
Waiting times (p)
Glaucoma (p)
Macular (p)
Number of false positive M2's from DRS (p)
MHTC
DNA rate in MHTC weekly (p)
Total number of DG8/9 eye patients seen weekly in MHTC (p)
RMS Triage process
New eye patient DG8/9 appointments triaged weekly to MHTC (appointment subtypes) (p)
New eye patient DG8/9 appointments triaged weekly to GCH (appointment subtypes) (p)
Qualitative in GCH
Patient
Waiting time in clinic (p)
Travel time to clinic (how much time saved compared to MHTC journey) (o)
Paid carers time off work (o)
Overall experience in relation to setting (b)
Staff
Opportunity (p)
Workload (b)
Joy / satisfaction in work (p)
Are we meeting our aim?
Weekly percentage split of appointments between MHTC and GCH patients from DG8/9 post codes (o)
Quantitative measure development
PDSA cycles
Staff
Patient