Renal Transplant - One stop assessment day

Summary of improvement

 

The Renal Transplant Team worked with Service improvement to improve and implement a one stop assessment day for Living donor transplant patients. They have developed a combined assessment process which is completed in one day.

Previously patients attended for 4 separate visits, (Echo, GFR EDTA, CT, Medical & surgical assessment) the process is now completed in one day. In addition to reducing the number of separate hospital visits, the team simplified the process on the day and also improved information provided to patients before the assessment day. The new approach provides a simpler, quicker and more timely assessment process.

Assessment and Diagnosis

 

The one stop assessment day combines key investigations for potential Living donor transplant patients. The team had already started building understanding of the key steps of the patient journey and revising the assessment process and had plans to integrate all of the key steps and multiple visits into one day before the Service Improvement team got involved.  .

Service Improvement helped the team to understand the process in more detail and  identify opportunities to improve the patient experience. This initial mapping helped the team visualise the patient journey, and the impact of using several different locations.

In simple terms, there were “Multiple steps, multiple locations, lots of walking….”

This was well supported by the patient feedback, which was collected at the time by shadowing patients:

“It would have been easier to wear a loose t-shirt so that access for blood tests was simpler…”

“It’s really difficult to find your way around the hospital….”

Treatment

 

With the support from the Service Improvement team the transplant team reviewed the learning and information gathered from the assessment of the patient journey and planned small scale tests at single patient level to build understanding of how to develop a new process to benefit patients.

Once multiple tests were completed, the team reorganised the time and made links with relevant departments involved to restructure the order of the day based on the patient experience feedback. The team liaised closely with Medical Physics and re-ordered the blood tests and worked with the existing out-patients team to complete bloods tests in one location.

All this work resulted in the new process map that had reduced number of Journeys and different locations used during the “One Stop assessment” day.

A revised process, to improve experience

Following the implementation of the new process, the team continued working with Service improvement on further developments and improvements to patient information provided both before the assessment day, and on the day itself, including clear directions around hospital locations, improved information about what is going to happen on the assessment day, how they should be prepared and what was going to happen next Following the assessment day, The patients return at a later date to discuss the outcome of assessments and potential living donor options.

Outcomes

 

Improved patient information and patient experience: The patients receive improved and detailed information about the plan for the day, hospital facilities, lunch and other refreshments in advance. On the day itself the patients are met in person by a member of the Renal Transplant team and receive an overview of the day.

Reduced number of visits: The number of separate hospital visits to complete the assessment process has reduced from 4 to 1 and assessments and investigations are completed during the  course of the assessment day.

Reduced number of locations and simplified process: The simplification of the process during the day reduced the number of journeys around the hospital site from 7 to 4.

Patient comments:

I was pleased to have a book with me for the inevitable short waits between appointments, but I would always take a book as I'd expect some waiting around. The information provided suggested this.

 

One stop assessment process - Definitely better all in 1 day

Next steps

 

The team are keen to continue developing the patient information to provide education and experience information. The team continue to meet on a regular basis and are also working to improve a number of areas within the Renal Transplant Service.

Contact: Kevin Firth (Improvement Facilitator - 0114 2265059) or Veronica Lennon (Transplant Manager - 0114 2715138)

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