Posters

Management of urgent care service: testing the need of systemic and/or digital records for an integrated ophthalmic service with learning extrapolations

Poster Details

First Author: M.Moutsou UK

Co Author(s):                        

Abstract Details

Purpose:

The aim of this study was to assess workload management & communication in the Urgent Service, as well as their impact on Routine Service over 3 years & through 2 sets of data. A different type of clinical summary/outcome sheet was used in the two sets of data.

Setting:

Queen Mary’s Sidcup, King’s College Hospital NHS Trust - London

Methods:

Data was collected from the manually completed outcome sheets of consecutive attendances in the Urgent Ophthalmic Care Service of Queen Mary’s Hospital Sidcup, over 2 weeks respectively in 2017 & 2014 and analysed by a single clinician. Whilst on the first set of data, free flow clinical summaries were used on the outcome sheets, the clinical summaries became structured and included choice options on the subsequent set.

Results:

Attendances increased for all days of the week by average 67.8% and workforce by 71.4%, whereas patient-clinician ratio decreased from 16.8 to 9.5. Overall clinical referrals decreased from 41.9% to 29.8% and requested departmental appointments from 38.1% to 26.3%. There was significant decrease of referrals to the on-call consultant from 13.5% to 4.5% and to the Primary Care Clinic from 7.2% to 2%, with 3% of cases being referred for the first time to Community Services in 2017 (Optician/ GP). Outcome sheets were incomplete for different types of information from 6.3% (name of clinician/ diagnosis) to 67.2% (duration of treatment).

Conclusions:

The study shows an increase of workload managed by adequate numbers of staff and involvement of Community Services over the past 3 years. It demonstrates a correlation between a more structured management/recording and reduction of the number of referrals. Furthermore, it signals the need for further recording improvements, standardised induction of staff and updated outcome sheets. Electronic recording should be considered in order to standardise medical information, facilitate storage and improve service efficiency & patient satisfaction.

Financial Disclosure:

None