Outpatients reform in the Child Development Program 01March 2012.
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Transcript of Outpatients reform in the Child Development Program 01March 2012.
Outpatients reform in the Child Development Program01March 2012
GP – Specialist Outpatient Project
Project Scope• 2 Year Project (2009 -2010)• Evaluation partner – UQ
Services in scopeRoyal Brisbane & Women’s Hospital• Urology Outpatients• Ophthalmology OutpatientsRoyal Children’s Hospital• Paediatric ENT• Child Development Program
GP – Specialist Outpatient Project
Aim of the project: To assign GPs to work with outpatient services to:• Understand issues faced by staff and specialists in OPD
clinics• Review current referral & discharge processes• Provide a GP perspective on referral and discharge
processes• Collaboratively work toward reducing waiting list. • Achieve better continuity of patient care
Child Development Program
GP Advisor - Dr Dana Newcomb
• Benchmarking nationally with services in Sydney, Melbourne, Perth, Gold Coast and Brisbane.
• Literature review on child development shared care models
• Interviews with senior CDP staff (Brisbane, Gold Coast, Sydney
• Identification of issues contributing to long waiting lists
Issues Identified
• Referral process• Lack of trust/understanding of roles• Internal processes
Referral Process
CDU
GPReferral Required
Other
Teacher
Parent
Assessment of Referrals
GP
Lack of Trust & Understanding of Roles
• Specialists did not discharge patients• Poor communication between specialists and GPs • Generally poor collaboration between CDP and
GPs• Lack of GP knowledge about developmental
disorders• Lack of GP awareness of other community
resource options• Poor collaboration between Community Child
Health Nurses and GPs
Internal Processes
• New patients were required to be seen by the specialist prior to receiving any allied health services.
• Wait times refer to the time waiting to see the specialist.
• Wait times for allied services vary, but generally relatively lengthy.
Development of a GP Liaison Role
GP Liaison Officer - Lesley Martin Work with the GP Advisor to:• Develop protocols which support Shared Care
Model • Define referral guidelines• Maximise use of Information Technology• Identify alternative community resource options• Develop an early identification tool• Collect service utilisation data
Data Collection
Clinical diagnostic data was collected over a three month period to discern the highest primary diagnoses with a view to service planning
1. Austistic Spectrum Disorder 2. Pervasive Developmental Disorder as a
secondary diagnosis 3. Intellectual impairment
50% of referrals in that time related to speech and language concerns of 0-2yr olds.
Outputs, Resources & Tools• The Red Flag Early Intervention Guide for
children 0 – 5 years. • eReferral template developed• Clear referral guidelines published• Centralized referral assessment process• Feedback to GP process introduced• Dedicated GP phone number• Intake officer – alternate options• GP Liaison – 116 GP visits to 47 practices
Outcomes: Referral Process
CDU
Assessment ReportOther
Teacher
Parent
Assessment of Referrals
GP
Outcomes
• GP phone line utilised - 41% of phone calls received were from GPs.
• 96% of GPs Surveyed were positive about the changes
• Waiting times were reduced from over 12 months to 10 weeks
GP Perspective
• Positive feedback from GPs
• Laminated Red Flag Resource displayed in Practices/Treatment rooms
• Practice visits well received
• GP referrals more qualitative and inclusive of pre-determining factors
• Secure messaging - direct referral link to central Clinical Intake at CDP
Paediatric Specialists’ Perspective
• Raised awareness of GP role
• Increased confidence to transfer review patients to GP care
• Letters to GPs have become more structured
• Recognition of enhancements achieved through electronic
communication
• Paediatric representation on Shared Care Working Party
Patient Perspectives
• Improved continuity of care
• Clearer referral pathway
• More timely response to referral and appointment
booking.
• Enhanced transition into adulthood for patients with life-
long complex developmental difficulties
In Summary
• GP input into OPD processes has made a
difference to waiting lists
• Electronic communication between OPD and GP
has streamlined processes
• This project has assisted with ongoing service
planning
For more details......
Helen HoareHealth Service Liaison ManagerMetro North Brisbane Medicare Local