Redesign of non-urgent outpatient services across metropolitan SA Health sites – SALHN Neurosurgery.
Duncan Lodge1 1Southern Adelaide Local Health Network, Bedford Park, SA, Australia2Flinders University, Bedford Park, SA, Australia
Abstract
Background
Outpatient waiting times for specialist review are a challenge in public health. Long waiting times impact quality of life, patient outcomes and health care system efficiency. In March 2020 SALHN Neurosurgical outpatient clinic had 708 non-urgent (mostly spinal) patients waiting, with median waiting times of over 2 years and a maximum of over 10 years. Evidence supports a range of strategies to reduce outpatient waiting times.
Aims
To propose and implement a novel model of care for non-urgent SALHN Neurosurgical spinal patients to positively impact wait times, quality of care, patient outcomes and resource implications.
Methodology
A mixed methodological knowledge translation approach was used. Data from prospective and retrospective observational studies of people currently on the SALHN neurosurgical waiting list was collected. A review of evaluated models of care for managing neurosurgical waiting lists was performed. Stakeholders suggested feasible evidence-based models of care. Models of care were developed to reflect the SALHN context, including estimation of resources required and modelling of expected effects on waiting lists. Stakeholders then selected the preferred model of care for implementation.
Results
Survey and interview results suggested patients on the SALHN Neurosurgical waitlist were negatively impacted and felt frustrated and demoralised. They were supportive of novel models of care to decrease wait times. Evidence review suggested that physiotherapists could safely and effectively manage non-urgent spinal patients referred for specialist opinion. Stakeholders supported physiotherapy involvement in the SALHN neurosurgical clinic with consultant oversight. Analysis of this model of care suggested cost savings and reduced wait times.
Conclusion
This project suggests physiotherapy assessment of non-urgent spinal patients referred for neurological review is cost effective and can reduce waitlists. It is supported by research evidence, SALHN consumers and health professionals.
Biography
Biographies to come