Uveitis is inflammation in the eye and can cause blindness without treatment. It is often linked with childhood arthritis. Uveitis needs a team of people to manage it properly: eye doctors (ophthalmologists), doctors with expertise using drugs to suppress inflammation (rheumatologists), optometrists, specialist nurses, pharmacists and sometimes psychologists.
Uveitis clinic is complex and patients are seen by a number of professionals during their visit. It is easy for patients to get delayed and have a longer visit than they need to. Members of the team have met regularly with a Microsystem Improvement Coach to make improvements.
The team timed lots of clinics to see how long patients were spending in clinic and made a series of changes. We have reduced the average time patients are at our clinic...
From 1 hr 27 mins to 59 mins
What changes have we made?
- Appointment length increased from 20min to 25min to reflect actual consultation length
- Short 10 minute team brief at the start of clinic to confirm the plan for each patient including tests. Having the receptionist part of the brief is crucial for ensuring good patient flow and improves communication
- Consistent team each week – same receptionist, dedicated Orthoptist to give continuity of care. Team names displayed on the wall for patients.
- Support Worker role added to the team to make the clinic is well
- organised – notes are in the correct place, ensure patients are seen in the right order and record height and weight
- Interruptions reduced so we can focus on the patient in the room
- Expectations set with patients by receptionist that multiple clinics are
- happening in the same Outpatient area, and therefore patients are not actually being seen out of order
- Better co-ordination with Medical Daycare to ensure notes are available in clinic
How have we done it?
- Regular Quality Improvement meetings, using the Clinical Microsystems methodology, supported by
an Improvement Coach
- Small iterative changes using Plan-Do-Study-Act cycles
- Regular measurement to show how processes are improving over time
- Different departments working together and communicating more effectively
"I feel the patients and family are truly benefited from the better quality of service and definitely much happier since the changes made through the process of microsystem improvement."
"It has been great to support the team in making a series of small changes that have had a big impact for patients."
Microsystem Improvement Coach