8 .1 Addition to waitlist

1. 7.1 First appointment for urgent patients 8.1 Addition to waitlist Narelle Basham – NUM, Specialist Clinics

2. 7.1 First appointment for urgent patients and 8.1 Addition to waitlist • The baseline • Four triage categories – two within ‘urgent’ timeframe • Referrals triaged as urgent usually added to new wait list (NWL) • Over 2000 urgent referrals on the NWL • No proper measures of wait times or time taken to add to wait list/make appointment once referral triaged • Targeted timeframes • Many urgent referrals NOT seen within designated time frame • Referrals added to waitlist or appoint made in designated time frame when staffing levels permitted

3. 7.1 First appointment for urgent patients and 8.1 Addition to waitlist • The baseline • Key challenges • Triage priorities not in-line with DoH priorities • Lack of consistency in how medical staff allocate priorities for triaging referrals • Referral management process (including triage) not meeting timeframes • Appropriate clerical staffing levels to manage referral throughput in a timely manner • Accuracy of NWL (9512 - July 2013) • Number of urgent referrals on NWL (2806 - July 2013) • Capacity to meet demand for referrals for urgent patients (see graph)

4. 7.1 First appointment for urgent patients and 8.1 Addition to waitlist • *Total new appointments – includes appointments available for rebooked DNA new patients which average 88/month • 54-57% of referrals received are triaged as Immediate or Urgent • When all things taken into consideration approx. deficit of 200 new appointment/month

5. 7.1 First appointment for urgent patients and 8.1 Addition to waitlist • Action plan • Initiatives Implemented with funding • NWL audit (focus on urgent referrals) (1 EFT clerical staff 6 months) • Implement revised triage processes with supporting documentation (0.31 EFT nurse project 6 months) • Milestones • Completion of audit of all urgent referrals on waitlist • Reduction in total number of urgent referrals on waitlist • Implementation of guideline for medical staff for prioritisation of referrals • Improved wait times for patients with urgent referrals • Commencement of audit of all routine referrals on waitlist

6. 7.1 First appointment for urgent patients and 8.1 Addition to waitlist Progress to date New Wait List & Urgent Referrals

7. 7.1 First appointment for urgent patients and 8.1 Addition to waitlist Progress to date Average waited times (days) to first appointment Calculated from patients who had first appointment in that month Also need to consider waiting time for patients still on WL – dashboard will provide that data too

8. 7.1 First appointment for urgent patients and 8.1 Addition to waitlist • Progress to date • Other achievements • Identification of improvements for triage process • Prioritise processing of referrals for clinics running that day • Triage to occur at start of clinic • 2nd referrals to be triaged by consultant only • Clinic coordinator role – includes overseeing referrals coming in • Ongoing challenges • Number of referrals received continues to increase (↑4% ) • Capacity to meet demand for referrals for urgent patients • How to manage routine patients • Competing demand with ESWL

9. 7.1 First appointment for urgent patients and 8.1 Addition to waitlist • On track? • Expect to meet most of timeframes outlined for the majority of referrals • Key Target unlikely to be met: • Providing appointment within 30 days for all urgent patients • But definitely on track to significantly improve on current wait times.