The Children’s Hospital at Westmead (CHW) is the largest paediatric tertiary healthcare facility in Australia, recognised for the role its outpatient services play in the delivery of patient-centred care. The hospital is part of the Sydney Children’s Hospitals Network (SCHN), which is in the process of reviewing its outpatient services and processes.
With growing patient demand, SCHN is committed to ensuring the delivery of optimal care, enhanced patient experience and improved efficiencies. This project looks at maximising the efficiency and effectiveness of outpatient services within the main outpatient department at CHW, focusing on Bandage Bear Clinics 1 and 2, the largest and busiest clinics at CHW. The team aim to implement solutions that lead to:
- improvement in patient, parent and carer and staff satisfaction
- reduction in ‘did not show’ rates and waiting times for clinics that have the highest ‘no show’ rates and wait times.
Identifying strategies to improve service delivery
Following a diagnostic phase, the following strategies identified were:
- Introducing a concierge volunteer service to manage traffic, provide a personalised service and identify and escalate potential patient, parent or carer issues.
- Changing clinic process so clinicians see patients by appointment time as opposed to arrival time, to enable equity and transparency and improve patient, parent and carer experience.
- Increasing NEXA queue-management system functionality; the NEXA kiosks at CHW have limited functionality. Full use of the system is being explored to better manage flow, enhance efficiencies and enable transparency.
- Implementing Patient Reported Outcome Measures to enable ongoing audit improvement cycles.
- Finding quick wins including equipment and changes in the layout of the administration staff check-in desk to improve staff workflow and communication with families.
These solutions are in the initial stages of implementation and an evaluation of quick wins has commenced. Communication strategies are being developed to inform patients, parents, carers and staff about solution implementation. A comprehensive evaluation of the implementation of prioritised solutions will be undertaken later in the year to identify if the goal and objectives of the project have been met.
Moving towards a more equitable system
Principal lessons learned:
- strong, supportive sponsorship is vital
- it is essential to consider the experience of those who will be impacted when planning to change a service
- key stakeholder buy-in and commitment is essential
- delegation of tasks and managing time are important for the project team members.
The success of this project will lead to a system that is more equitable, responsive, transparent and outcomes-focused, aiming to improve patient outcomes and provide an outpatient environment that is respectful, family-friendly and safe.
