Primary care providers in Salford are managing patient actions and accessing up to date information from over 20 different clinical systems, with significant variation between providers and individuals in how these are being used. As new services are being developed, such as Salford Wide Extended Access Programme (SWEAP), requiring interaction between clinicians using these systems, clinicians have identified a need to streamline task management processes.
With support from the Improvement Science for Leaders (IS4L) programme, a team from Salford Primary Care Together (SPCT) took on the challenge to improve processes for managing tasks in primary care, with an initial focus on the SWEAP service. Prior to the project, the team identified the potential risks of the two-week wait (2WW) referral process. The initial project aim was to ensure that 95% of 2WW referrals were accurately processed by June 2019 whilst learning and applying QI methods.
The team sought to develop a method to ensure that 2WW referrals were made accurately and patients reliably received appointments. To implement this, the team adopted a Quality Improvement (QI) approach using process mapping to understand the system and the problem and a driver diagram to highlight dependent factors and change ideas. The team tested Plan Do Study Act (PDSA) cycles, such as staff training and using an e-referral proforma for SWEAP clinicians.
Throughout the project, the team identified several challenges, including;
Despite not achieving the project aim, the work the team did ensured that 100% of patients received a 2WW appointment. The team have set up an intuitive data dashboard to reliably monitor the process and continue to use QI methodology to test changes. Feedback from focus groups further revealed areas for improvement and the team also identified a number of learning outcomes, including;
The next phase of the project will involve qualitative analysis and a presentation to stakeholders.