Miss Isabel Schueler1, Ms Helen Evett1, Ms Maria O'Sullivan1, Ms Grace Stewart1, Ms Sohaila Nowrozi1, Dr Julianna Bailey1
1The Alfred Hospital, Melbourne Australia
Biography:
Isabel Schueler is an Accredited Practising Dietitian with four years of experience in various clinical settings. She is currently in the role of Lung Transplant Dietitian at Alfred Health serving both adult and paediatric patients. She is passionate about providing holistic nutrition care to medically complex patients with chronic disease. Research interests include energy expenditure and body composition changes in transplant recipients.
Abstract:
Background:
Timely nutrition care is crucial for lung transplant recipients, improving medical and functional outcomes. Our goal is to enhance Lung Transplant Nutrition service provision through streamlining referral, triage, and scheduling pathways. Baseline data revealed extended wait times and a wait list of 117 post-transplant patients requiring outpatient nutrition appointments. Specifically, our aim was to reduce the wait list for post-lung transplant nutrition reviews by 50% over a timeframe of 3 months.
Methods:
The Model for Improvement framework was used to redesign the Lung Transplant Nutrition service. A literature review, benchmarking against national and international transplant centres, and a baseline audit identified key areas for improvement and informed process changes. Interventions included utilisation of a Nutrition Assistant to schedule overdue and urgent reviews, a digital system to track patient status, and a new community referral algorithm.
Results:
The waitlist was eliminated within one month of implementation, and zero patients have been waiting for follow-up appointments over the past six months since implementation. Prior to interventions, 62% (n = 73) of patients on the waitlist were overdue or required review within three months. Post interventions, wait times were reduced by 75%, and patients are now scheduled within 1-3 months post-transplant based on clinical priority.
Discussion:
These interventions enabled full clearance of the waitlist for dietitian assessment, helped track demand and identify post-transplant nutritional needs. We have created a sustainable model that ensures timely care and will allow the service to evolve further and respond to emerging patient and system needs.