The reduction of RTT for in house paediatric dento-alveolar patients to less than 18 weeks

Quality Improvement Poster Download

Background & Problems

It was highlighted when looking at patients treated in the Oral and Maxillofacial Surgery Department that the longest waiters were paediatric patients following internal referrals from our orthodontic colleagues to surgery. A retrospective case note review of all orthodontic surgeries in 2017 showed an average wait of 329 days with long waits in decision to refer date and initial consultation for surgery (av 138 days). Admin time was much longer than initially expected (av 40 days).Patient experience was also poor because of a long wait for their surgery and an extra consultation appointment, which extended their overall orthodontic treatment time.

Aim

• To improve the referral to treatment time of internal orthodontic patients to under 18 weeks
• Improve patient experience
• Reduce admin time
• More efficient use of clinic slots
• Fewer lost notes/ radiographs.

Method

A direct referral system was implemented to allow for same day referrals from Orthodontic Consultants to a member of the Oral and Maxillofacial Surgery team to be absorbed on to an already booked clinic. A direct referral bundle, to include a newly designed form, removed the need for a dictated letter to be typed/scanned/vetted and booked for a subsequent clinic. This bundle was merged by a designated secretary in to the main hospital notes.

Results

Since introduced all patients (9 so far have had their surgery since implementation in July 2018) were treated within 18 weeks from an average wait of 329 days before to an average of 62. Patient experience was also improved.

Implications

We have a very engaged team therefore the project went very well. The direct referral system has been implemented permanently. There is the potential for this to be used in different specialities that encompass different, but linked sub-specialities that run in a similar way.