Children Community Health

 

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  • QI 145 Reducing Length of Wait for Assessment For Children's Speech and Language Therapy
    Tregonning, Julie; Supported by the Quality Improvement Team, Coventry and Warwickshire Partnership Trust; Tregonning, Julie; Speech and Language Therapy; Allied Health Professional; Coventry and Warwickshire Partnership NHS Trust (Coventry and Warwickshire Partnership NHS Trust, 2024)
    Aim: To reduce length of wait to achieve 92% of children being assessed within 18 weeks of referral by June 2024 This project was carried out to address the waiting time for initial assessment in Children’s SLT. Prior to May 2021 the 18 week RTT target (92%) was achieved, but due to a COVID backlog, reduced capacity and increased referrals, children were waiting considerably longer from May 2021, with a low point of 41% in June 2023. A number of change ideas were tested but most had little impact on the waiting times. Therefore additional investment was supported by CWPT executives for a Patient Flow Coordinator to assist with addressing waits for Children’s SLT. The target has been temporarily amended from 92% to 80%, to have the least impact on the waiting times for follow ups and intervention (balancing RTT:ATT). Tools Used: Process Mapping; Driver Diagram; Theoretical Capacity; PDSA. Project Impact: 89% of children are seen within 18 weeks of referral.

  • QI 144 Improving Upper Limb Splinting for Young People in Coventry
    Puri, Rinku; Prescott, Gemma; Supported by the Quality Improvement Team, Coventry and Warwickshire Partnership Trust; Puri, Rinku; Prescott, Gemma; Occupational Therapy; Allied Health Professional; Coventry and Warwickshire Partnership NHS Trust (Coventry and Warwickshire Partnership NHS Trust, 2024)
    Aim: To reduce the waiting time for splints for young people in Coventry from a maximum of 174 days to a maximum of 7 days by June 2022. Children and young people were assessed once a year in the Hand Splinting Clinic and were issued with prefabricated splints. Delays of up to 174 days were caused if the required splints were not in stock due to splints being ordered from overseas. The cost of these splints and staffing was around £105.00 per splint. The delays resulted in some splints not fitting the children by the time they had arrived due to growth, leading to excess stock and reordering. This improvement project aimed to reduce waiting times and costs. Tools Used: PDSA Cycles - https://aqua.nhs.uk/wp-content/uploads/2023/07/qsir-pdsa-cycles-model-for-improvement.pdf; Process Mapping - https://aqua.nhs.uk/wp-content/uploads/2023/07/qsir-mapping-the-process.pdf. Project Impact: We achieved a reduction in waiting times from up to 174 days to 0 days leading to better patient experience. The average cost of fitting a splint reduced from £105 to £80. Fabricated splints cost less. We saved approximately £6000 over the last financial year.

  • QI 149 Increasing Referrals to the Children’s Cerebral Palsy Strengthening Group
    Chapman, Jenny; Supported by the Quality Improvement Team, Coventry and Warwickshire Partnership Trust; Chapman, Jenny; Physiotherapy Services; Allied Health Professional; Coventry and Warwickshire Partnership NHS Trust (Coventry and Warwickshire Partnership NHS Trust, 2024)
    Aim: Increase the referral rate for the Cerebral Palsy strengthening group from 0% in March 2022 to 80% by September 2023. A virtual group was set up in 2021 for children and young people with Cerebral Palsy. As Covid restrictions reduced there was a noted decrease in referrals and an increase in requests from parents to move the group from virtual to face to face. The project was initially set up in March 2022 to scope the barriers to referral and attendance and improve the referral rate into the group. Increasing referrals would mean that sufficient outcome measures could be collected to evaluate clinical effectiveness of treatment. Tools Used: PDSA Cycles - https://aqua.nhs.uk/wp-content/uploads/2023/07/qsir-pdsa-cycles-model-for-improvement.pdf; Driver Diagram - https://aqua.nhs.uk/wp-content/uploads/2023/07/qsir-driver-diagrams.pdf; Sustainability Tool - https://aqua.nhs.uk/wp-content/uploads/2023/07/qsir-sustainability-model.pdf. Project Impact: The referral rate increased to 81% of the full capacity for the group. Seeing patients in a group rather than 1:1 has: Saved 18 hours of staff time per cohort (108 hours of clinical time saved over the last year). £373.74 has been saved per cohort. This equates to savings of £2242 over the last year and up to £2616 next year. Attendance at the groups has enabled us to collect and compare data through outcome measures. These have shown large clinical benefits which have been maintained when 1 year post group outcome measures have been repeated. Average improvement in 6 minute walk test (6MWT) scores for GMFCS 1 and 2 patients show a statistically significant improvement. The group has progressed to running face to face and since re-starting in January 2023 has successfully run with patients within each group and referral rates above 50% maintained in each cohort. All patient feedback has been positive. The average improvement in strength (MRC) showed increase or maintenance in all areas for each patient.