Embed Size (px)
Citation preview
Physiotherapy Outpatient Efficiency : a project that reduced DNAs by 47.7%
Sally Greensmith MCSP HCPC, NHS Clinical Leadership Fellow
Contact Details: Sally Greensmith PMO Project Manager Chertsey House St Peter’s Hospital KT16 0PZ 01932 723727 @Sally2PT [email protected]
64%
22%
10%
3% 1%
Patient Satisfaction
very
satisfied
moderately satisfied
neither satisfied nor dissatisfied
moderately dissatisfied
very dissatisfied
The Problem • Missed appointments cost the NHS £600m per year1
• UK national average DNA rate for outpatients 7.5%2
• Ashford and St Peter’s Hospitals NHS Foundation Trust
physiotherapy outpatient DNA rate 13.2%
• Telephone reminders unsuccessful in reducing DNAs
Objectives • Reduce DNA rate to national average of 7.5%2
• Improve first appointment slot utilisation
• Maximise available income from attendances
Project Set Up • Benchmarking with other local NHS Trusts
• Staff engagement
• Changes to electronic diary templates
• Set up call monitoring system on a dedicated telephone line
• Telephone clerk recruited
• Booking letters sent for all routine first appointments
• Patient feedback forms devised
Pilot Phase
• Initial plan for 4 months from July 2012
• DNA data analysed monthly
• Initial results demonstrated a reduced DNA rate for
patients using the telephone booking service (see below)
• The proportion of appointments booked in this way was
increased to 30% of all first appointments
• Pilot phase extended by 3 months
Results
• DNA rate reduced to 6.9% • Waiting lists reduced to 6 weeks through improved
appointment slot utilisation and patient throughput
• Increased income by £1,720/month
• 86% of 157 patients were satisfied with the service
Financial & Efficiency Benefits • 43 more new patients seen per month
• Increased income by £1,720/month = £20,240/annum
• Phone clerk costs approx. £8,000/annum
• Net gain £12,240/annum • 516 more patients seen/year; routine waiting list reduced from
20 to 6 weeks
Telephone line opened
“Good service”
“Helpful and
quick”
“Very pleasant
staff”
1Dr Foster website. Available: http//www.drfosterhealth.co.uk/features/ outpatient-appointment no shows.aspx. Accessed 2013 April 26 2Health and Social Care Information Centre (2012) Hospital Episode Statistics : Hospital Outpatient Activity 2011-12. Health and Social Care Information Centre
Future Implications • The telephone booking service should be continued
• Increase the proportion of appointments booked by telephone
for further financial and efficiency gains
0
5
10
15
20
25
30
35
40
45
Percen
tag
e
%DNA vs %Booked by Telephone
appointments booked by telephone
DNA Rate
Linear (appointments booked by telephone)
Linear (DNA Rate)
Significant fall in DNA rate here
