Staff at South London and Maudsley NHS Foundation Trust have reduced waiting times for mental health patients after redesigning their referral system.
The results show around a 20% increase in patients seen within target referral times and are published in BMJ Quality Improvement Reports today - an open access forum to help clinicians share improvement ideas.
Anaectodal evidence suggested that waiting times within the older adults community mental health team (OA CMHT) covering the south area of the London Borough of Croydon had been increasing.
The team manage about 400 patients aged 65 and over, with mental health disorders including dementia, mood disorders, and delusional disorders.
They aim to see all routine referrals within 15 working days of referral, and all urgent referrals within three days, to improve prognosis and prevent distress to both the patient and their family.
In 2011, a 'duty worker' assessed all referrals on a daily basis. Around 77% of all routine cases were seen within 15 working days and 66% of all urgent cases were seen within three working days. Average waiting times were 12 days for routine cases and 3.6 days for urgent cases.
However due to staff shortages, this system was changed by 2013 to a weekly meeting where new referrals were discussed.
A re-audit in 2013-14 showed that 65% of routine cases were seen within 15 working days and 11% of urgent cases were seen within three days. Average waiting times increased to 16 days for routine cases and to 10 days for urgent cases.
To address this problem, the team decided that a duty worker role was necessary.
Despite fewer staff, they were able to consolidate resources and re-introduce the duty system to ensure that all urgent cases were highlighted early and acted upon.
Initial findings from September 2014 to February 2015 suggest an improvement in average waiting times and percentage of assessments reviewed.
Results show 85% of all assessed routine cases were seen within 15 working days and 36% of urgent cases were seen within three days. Average waiting times were 10.7 days for routine cases and 6.8 days for urgent cases.
Despite some limitations, the outcomes of this study have demonstrated an improvement of both waiting times and percentage of patients being seen within set standards following a single intervention, write the authors.
"In the current climate of cost efficiency savings, it is important for services to continue to find ways to streamline and improve upon current practices, to ensure the best outcome for patients within the limitations of financial and manpower restrictions," they conclude.
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Journal
BMJ Quality Improvement Reports