QI 172 Improve Time Taken From Referral to Assessment in Children's Dysphagia Service

Abstract

Aim: To streamline the processes in Children’s Dysphagia initial assessment.

This project was carried out to maximize reduced capacity, whilst maintaining the 10 day KPI for initial assessments. A variety of tools were used to understand where the issues were. During process mapping it became clear that there were two areas of focus, Triage and Attend Anywhere (AA). All families were contacted by telephone for a triage appointment by the speech and language therapist (target of within 10 working days) and were then all booked into a face to face or AA assessment. As they were all booked into an assessment appointment at a later date, following triage, this was causing a delay for assessment. A large number of AA appointments were needing to be rebooked due to failed assessments and were then being rebooked into another initial assessment rather than a follow up slot. The team all agreed that this client group was difficult to assess via AA. Triage has been taken out of the process and the patient flow team are now booking all new referrals in with a speech and language therapist for their initial appointment, face to face, within a target of 10 working days.

Tools Used: Driver Diagram - https://aqua.nhs.uk/wp-content/uploads/2023/07/qsir-driver-diagrams.pdf; Process Mapping - https://aqua.nhs.uk/wp-content/uploads/2023/07/qsir-conventional-process-mapping.pdf; SPC Chart - https://aqua.nhs.uk/wp-content/uploads/2023/07/qsir-statistical-process-control.pdf; PDSA - https://aqua.nhs.uk/wp-content/uploads/2023/07/qsir-pdsa-cycles-model-for-improvement.pdf.

Project Impact: On average the number of children seen within 10 days of referral has increased from 17% to 57%. Six steps have been removed from the process and bookings for assessment have been moved to an admin function.