A quality improvement project to reduce the waiting time between referral and service start times in a Scottish hospice.

Caroline Sime, Bett, Paul, Stuart Milligan, Mills, Anne, Kevin Rooney

Research output: Contribution to journalMeeting Abstract

Abstract

Background
Appropriate and timely admission to hospice care can result in significant benefits for people living with life limiting disease (Meier, 2011). However, there can be delays in services commencing. Causes for delay may be communication and administrative barriers, restrictions on the days/times when admissions can take place and the non-availability of services (Aldridge Carlson et al, 2012). The Clinical Standards Board for Scotland (CSBS, 2002) recommends that from time of referral to initial contact with specialist palliative care services should be a maximum of two working days. Yet, a national review of palliative care services in Scotland identified a gap in current information on palliative care provision (Clark, 2015).
Aims
Within Ardgowan Hospice, our aim was to improve the referral process to hospice services by identifying barriers and bottlenecks in the referral process.
Methods
Using improvement methodologies, we process mapped the patient journey to identify areas of delays. We then created run charts using existing data to plot current waiting times to explore the variation and medians in wait times for different hospice services. We then used Plan, Do, Study, Act (PDSA) Cycles to test change ideas and record what happened during, and after the test.

Results
Process mapping of referrals to hospice services identified a complex administrative process within the hospice, often leading to inaccurate data collection. Testing change ideas to improve the accuracy of the data collected resulted in the overall median time of referral to service start for hospice services halving from 4 days to 2 days.

Conclusions
Using improvement methodologies within a hospice setting has improved the accuracy of current data collection, thus contributing to the body of knowledge required for the future development of palliative care services in Scotland.
Original languageEnglish
Pages (from-to)S4-S5
JournalPalliative Medicine
Volume30
Issue number4
DOIs
Publication statusPublished - Apr 2016
EventPalliative Care Congress: The 11th Palliative Care Congress - SECC, Glasgow, United Kingdom
Duration: 9 Mar 201611 Mar 2016

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Hospices
Quality Improvement
Referral and Consultation
Palliative Care
Scotland
Communication Barriers
Hospice Care

Cite this

Sime, Caroline ; Paul, Bett, ; Milligan, Stuart ; Anne, Mills, ; Rooney, Kevin. / A quality improvement project to reduce the waiting time between referral and service start times in a Scottish hospice. In: Palliative Medicine. 2016 ; Vol. 30, No. 4. pp. S4-S5.
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abstract = "BackgroundAppropriate and timely admission to hospice care can result in significant benefits for people living with life limiting disease (Meier, 2011). However, there can be delays in services commencing. Causes for delay may be communication and administrative barriers, restrictions on the days/times when admissions can take place and the non-availability of services (Aldridge Carlson et al, 2012). The Clinical Standards Board for Scotland (CSBS, 2002) recommends that from time of referral to initial contact with specialist palliative care services should be a maximum of two working days. Yet, a national review of palliative care services in Scotland identified a gap in current information on palliative care provision (Clark, 2015). AimsWithin Ardgowan Hospice, our aim was to improve the referral process to hospice services by identifying barriers and bottlenecks in the referral process.MethodsUsing improvement methodologies, we process mapped the patient journey to identify areas of delays. We then created run charts using existing data to plot current waiting times to explore the variation and medians in wait times for different hospice services. We then used Plan, Do, Study, Act (PDSA) Cycles to test change ideas and record what happened during, and after the test.ResultsProcess mapping of referrals to hospice services identified a complex administrative process within the hospice, often leading to inaccurate data collection. Testing change ideas to improve the accuracy of the data collected resulted in the overall median time of referral to service start for hospice services halving from 4 days to 2 days.ConclusionsUsing improvement methodologies within a hospice setting has improved the accuracy of current data collection, thus contributing to the body of knowledge required for the future development of palliative care services in Scotland.",
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A quality improvement project to reduce the waiting time between referral and service start times in a Scottish hospice. / Sime, Caroline; Paul, Bett,; Milligan, Stuart; Anne, Mills,; Rooney, Kevin.

In: Palliative Medicine, Vol. 30, No. 4, 04.2016, p. S4-S5.

Research output: Contribution to journalMeeting Abstract

TY - JOUR

T1 - A quality improvement project to reduce the waiting time between referral and service start times in a Scottish hospice.

AU - Sime, Caroline

AU - Paul, Bett,

AU - Milligan, Stuart

AU - Anne, Mills,

AU - Rooney, Kevin

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N2 - BackgroundAppropriate and timely admission to hospice care can result in significant benefits for people living with life limiting disease (Meier, 2011). However, there can be delays in services commencing. Causes for delay may be communication and administrative barriers, restrictions on the days/times when admissions can take place and the non-availability of services (Aldridge Carlson et al, 2012). The Clinical Standards Board for Scotland (CSBS, 2002) recommends that from time of referral to initial contact with specialist palliative care services should be a maximum of two working days. Yet, a national review of palliative care services in Scotland identified a gap in current information on palliative care provision (Clark, 2015). AimsWithin Ardgowan Hospice, our aim was to improve the referral process to hospice services by identifying barriers and bottlenecks in the referral process.MethodsUsing improvement methodologies, we process mapped the patient journey to identify areas of delays. We then created run charts using existing data to plot current waiting times to explore the variation and medians in wait times for different hospice services. We then used Plan, Do, Study, Act (PDSA) Cycles to test change ideas and record what happened during, and after the test.ResultsProcess mapping of referrals to hospice services identified a complex administrative process within the hospice, often leading to inaccurate data collection. Testing change ideas to improve the accuracy of the data collected resulted in the overall median time of referral to service start for hospice services halving from 4 days to 2 days.ConclusionsUsing improvement methodologies within a hospice setting has improved the accuracy of current data collection, thus contributing to the body of knowledge required for the future development of palliative care services in Scotland.

AB - BackgroundAppropriate and timely admission to hospice care can result in significant benefits for people living with life limiting disease (Meier, 2011). However, there can be delays in services commencing. Causes for delay may be communication and administrative barriers, restrictions on the days/times when admissions can take place and the non-availability of services (Aldridge Carlson et al, 2012). The Clinical Standards Board for Scotland (CSBS, 2002) recommends that from time of referral to initial contact with specialist palliative care services should be a maximum of two working days. Yet, a national review of palliative care services in Scotland identified a gap in current information on palliative care provision (Clark, 2015). AimsWithin Ardgowan Hospice, our aim was to improve the referral process to hospice services by identifying barriers and bottlenecks in the referral process.MethodsUsing improvement methodologies, we process mapped the patient journey to identify areas of delays. We then created run charts using existing data to plot current waiting times to explore the variation and medians in wait times for different hospice services. We then used Plan, Do, Study, Act (PDSA) Cycles to test change ideas and record what happened during, and after the test.ResultsProcess mapping of referrals to hospice services identified a complex administrative process within the hospice, often leading to inaccurate data collection. Testing change ideas to improve the accuracy of the data collected resulted in the overall median time of referral to service start for hospice services halving from 4 days to 2 days.ConclusionsUsing improvement methodologies within a hospice setting has improved the accuracy of current data collection, thus contributing to the body of knowledge required for the future development of palliative care services in Scotland.

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DO - 10.1177/0269216316631462

M3 - Meeting Abstract

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SP - S4-S5

JO - Palliative Medicine

JF - Palliative Medicine

SN - 0269-2163

IS - 4

ER -