QI 1221 Reducing Urgent Community Response (UCR) Service Rejections

Abstract

Aim: To achieve a 25% reduction in senior clinical reviews from an average of 52 per month in Q1 2023 to a target of 39 in Q3 2023.

A clinical audit was undertaken in December 2022 by the Advanced Consultant Clinical Practitioner in the UCR service; SQ1132 Urgent and Emergency Care Clinical Audit Toolkit. The audit highlighted significant discrepancies in the use of the UCR follow-up clinical review process, which allows UCR clinicians to keep patients on the acute medical caseload for up to 72 hours. Consequently, an improvement project was proposed to reduce the burden of clinical reviews with the UCR senior clinicians’ cohort.

Tools Used: PDSA Cycles - https://aqua.nhs.uk/wp-content/uploads/2023/07/qsir-pdsa-cycles-model-for-improvement.pdf; Driver Diagrams - https://aqua.nhs.uk/wp-content/uploads/2023/07/qsir-driver-diagrams.pdf

Project Impact: The average number of senior clinical reviews decreased from 52 in quarter 1 to 26 in quarter 3. A reduction of 50%. 780 minutes of senior clinician patient facing time were freed up each month - 156 hours per year. Cost savings of £290.68 per month and £3488.16 per year.