Director of Operations and Nursing Report Enclosure Ji by A9Not2G


									       Outpatient Service Improvement Plan (SIP's) including Key Point Indicators (KPI's)
           KPI             Lead                    Target                        Currently                             Action                               Update
                                       Implement actions from                                                                          New process in place, we do not
                                       Access Policy                                                                                   bring forward patients if less than
                                                                                                Manager and Team Leaders have          two weeks. Wording in letters
                     Bev                                         95%of current Outpatient       reviewed the draft 18 week policy      has changed and DNA process
Access Policy/Audit
                     Ackland/Nicky                               standards are met. New         currently waiting for written          developed, dedicated line for
                     Mills         Audit 18 week processes       working practices introduced guidelines and confirmation of 18        DNA patients. Currently looking
                                                                 after PAS upgrade to be        week protocol. In the meantime         at Rescheduled process.
                                                                 monitored in line with 18      staff have been verbally informed of Compliance monitoring
                                                                 week RTT rules                 changes they need to be aware of. continued
                                                                                                6 Call Handlers logged in at any one
                                                                                                time. Dedicated clerks to log in until
                                                                                                we are able to train additional staff October response times at 80%.
Call centre Response Sara                                                                       to handle calls during peak periods. Changes within the department
                                   Agree and monitor Call Centre
Times (telephone     Wilson/Jane                                 There are 4 Call Handlers      Look at resources to see if it is      will hopefully see the increases
                                   Performance standards.
calls)               Farrell                                     employed specifically for this viable to re-allocate staff in other   continue. Additional message
                                                                 role but they work a shift     areas to call handle. Develop          informing patient whereabouts
                                                                 pattern covering 8.30am-       performance reports on a monthly       they are in the queue and when
                                                                 18.45pm                        basis                                  best to contact at less busy times
                       Bev           Lack of slot availability for staff
                                                                         Speciality Liaison. Reports                                           Validation complete Work Load
Capacity               Ackland/Nicky to make necessary
                                                                         produced weekly for           Pilot looking at feasibility of using   Planning Group given up to date
                       Mills/AGM's   appointments
                                                                         capacity shortfalls           Follow-up waiting lists in PAS.         data, looking at additional clinics.
                                                                                                                                               Named clinician roll-out to start
                                                                                                                                               15th November - Gynae, 15th
                                                                                                                                               December Surgical, 7th February
                                                                                                                                               Medicine, 7th March
                       Sara            Reduce slots to a 5 week wait                                                                           Opthalmology. Following these
Choose and Book
                       Wilson/Elaine   and reduce slot unavailability                                                                          timescales the 'Advice and
                       Billings        to 10% by year end                                              Information submitted to workload       Guidance' will be switch on.
                                                                                                       Planning Group in form of the           Dietetics, Opthalmology and
                                                                        Arrange between 8-10           indicative wait and slot polling        Cardiology to go from Indirect
                                                                        weeks and end of October       report. Capacity issues need to be      booking (IDS) to Direct Booking
                                                                        slot availability 11%          resolved, additional clinics required   (DBS) between Jan-March 2011
Clinch Process         Shaw -         New style form unusable                                                                                  Re-design clinches in use.
                       Secretary team                                   Re-design form - more user                                             Monitoring compliance and
                       leader                                           friendly                   End of September                            reason for change
        KPI               Lead                  Target                         Currently                            Action                               Update

                                                                                                                                             On hold. Trust looking at
                                                                                                                                             scanning of Health Records and
                                     Too many databases to be
                      Bev                                                                                                                    other information and will
                                     opened to enable making of
Dashboard             Ackland/Mark                                                                                                           incorporate this change with the
                                     an appointment causing
                      Keene                                                                                                                  dashboard facility for consultants.
                                     slowing of PC's
                                                                                                                                             Change form re-submitted for
                                                                      Looking at 'Dashboard'                                                 consideration at next IT
                                                                      facility for OPD clerks         End of December                        Committee meeting 17.11.10
                                                                                                                                             All issues and requested
                                                                                                                                             changes are currently on hold.
                                                                                                                                             Looking into feasibility of using
                      Bev                                                                             Investigate possibility of             the Follow-up waiting lists on
Follow Up Database    Ackland/Nicky Reduce F/Up Backlog                                               automatically generated reports to     PAS. In the meantime we can
                      Mills/AGM's                                                                     identify patients over threshold and produce lists via screen prints.
                                                                                                      by how long have appointments          Database validated, outstanding
                                                                      Reductions have not been        been delayed. Work with AGMs to        appointments identified to AGM's
                                                                      achieved in F/Up Backlog.       identify additional capacity required. for additional clinics.
                                                                                                                                             Currently HRD achieve 99% of
                                                                                                                                             records to clinics. With the short
                                                                                                                                             notice received in OPD for extra
                      Bev           Inform Health Records (HRD)
                                                                                                                                             clinics/late slot staff are under
Health Records - Late Ackland/Nicky immediately late additions are
                                                                                                                                             pressure to fill slots, it is
additions             Mills/Karen   recognised. Ideally 4 days
                                                                                                      BA to send KO copy clinches            sometimes impossible to reach
                      Olorenshaw    notice required
                                                                      Not all information filtering   received for late clinics. Nicky Mills patients allowing enough notice
                                                                      through to HRD in a timely      to ensure any late additions to        for HRD to obtain records in time
                                                                      manner                          clinics are emailed to HRD.            for clinics

                                                                                                      Advertise and appoint C&B Lead         Sara Wilson has been appointed
Implement change to                  Appoint additional senior post                                   and develop team to reflect new        as the Choose and Book lead
Outpatient                           and review current staffing                                      structure to be more outwardly         covering the reception/referral
Department Structure                 bandings and allocation                                          focused to support improved referral   and call handling staff. The new
                                                                                                      process and communication with         department structure to be
                                                                                                      GPs and practice staff.                distributed..
        KPI               Lead                  Target                      Currently                           Action                              Update
                                                                                             Include information regarding best
                                                                                             times to contact call centre/E-mail
                                                                                             address and information around
Communication with
                      Bev            To improve the Patient                                  appointments being brought forward
Patients through
                      Ackland/Sara   Experience through improved Patients need to appreciate on appointment letters. Contact
Appointment Letters
                      Wilson         communication               appointments maybe          patients where possible to negotiate
and Telephone
                                                                 brought forward when        appointment dates & times. Produce Email address/DNA information
                                                                 capacity becomes available information leaflet around telephone included in letters. Good
                                                                 earlier.                    text                                 response from email users
                                                                                                                                  21,000 patient identified have all
                                                                                                                                  been checked, those relating to
                                                                                                                                  waiting lists and other
                                                                                                                                  departments have been
Lost appointment      Maureen
                                     Validation                                                                                   forwarded for each area to
Validation            Cooper
                                                                                                                                  validate the information and
                                                                                                                                  close where necessary. Ongoing
                                                                 Re-train staff to complete                                       monthly reports to be distributed
                                                                 closures correctly          Urgent                               to individual areas

                                                                                                   Capacity issues need to be resolved
                      Bev                                                                          information submitted weekly to       New style PTL based on 18
OPD waiting times for
                      Ackland/Work New appointments to be                                          Work Load Planning group. Agree       weeks indicates capacity
new patient
                      Load Planning booked < 5 weeks                                               target times by specialty as some     requirements required to reduce
                      team                                                                         outpatient based specialties maybe    to <5 weeks. Issued 1st and 3rd
                                                                   up to 10 weeks on average       up to 10 weeks, i.e. Ophthalmology    Wednesday of month. Waiting
                                                                   but dependant on specialty      and Dermatology.                      for AGM feedback
                                                                                                                                         Changes in staff and additional
                      Bev                                                                                                                resource plus regular meetings
Orthopaedics          Ackland/Claire Problems around bookings                                                                            with clinicians, AGM and admin
                      Hinds/Marie                                                                  Regularly meetings to be arranged     team involved has proved to be
                      Ritson                                       Workshop with key staff         with key staff                        productive
                                                                                                                                         Currently working with
                                                                                                                                         consultants on clinic templates
Outpatient Booking                  Updated requirements for all                                                                         and specific clinic rules for
Policy                              specialties                    Set up meetings with                                                  specialties and changes around
                      ated Clerks
                                                                   Consultants/Secretary/Team                                            their job plans that may impact
                                                                   Leader/Dedicated clerks    Completion of policy end 2010              on OPD workloads
                                                                                                                                         Not all outcome sheets returned
                      Sara Wilson/
                                                                                                                                         to receptions despite requests
Outcomes (Pinks)                       Outcomes - Missing Pinks    Audit to take place to see if                                         from staff. Linda Holland has
                                                                   specific specialty or across                                          been informed, she will liaise
                                                                   board                           End November 10                       again with specialties
        KPI              Lead                 Target                    Currently                       Action                             Update
                                                                                         Action Plans developed for all        Multiple reschedules to be
                                                                                         Specialties and for Booking           reduced. Waiting on Information
                   Claire        Target to Reduce                                        Services. Monthly Performance         Department to provide individual
Reduce Reschedules Hinds/AGM's/O Reschedules from 12% to 5 %                             Monitoring with quarterly detailed    patients details to allow further
                   PD staff      by year end                                             analysis by Booking Staff and other   interrogation for those who have
                                                             April 2010 = 2841 >October Trust departments booking              multiple changes to identify if
                                                             2010 = 1800                 appointments                          patients or hospital reschedules
                   Bev                                       Send report to Claire Hinds                                       Three standards regular not
                                 Monitor OPD standards on a
Standards          Ackland/Team                              for the Patient Experience                                        achieved due to outside factors
                                 monthly basis.
                   Leaders                                   Group and F & P             1st Wednesday of each month           Ongoing

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