For several months, a process to cancel unwanted patient appointments triggered upon receipt of an incoming text message has lowered the Trust's DNA and prevented thousands of unwanted patient appointments being wasted.
Once a process has gone live, it is good practice to implement a continuous improvement program. It is likely that flaws in the process will be identified as detailed audit analysis from the control room become available.
In the case of the patient appointment cancellation process, it was observed that the patient was not acknowledging some text messages and telephone calls. The Trust's Patient Administration System (System C Medway PAS) is not spine enabled. This means that Patient demographic changes made on GP systems are not actively amended on PAS. For some patients, it was observed that contact was being made to an old telephone number. To improve the successful 'hit rate' for message acknowledgement, a new process has been developed.
So what happens now?
Daily, the responses from the telephone text reminder service are audited. For those without a reply, a check is made on the Electronic Referral System (ERS) to see if the patient contact details on the original referral are different to those held on the Patient Administration System (PAS). Where there is a difference in the telephone number stored on PAS is updated on Medway. This is not a simple process.
Changes to a patient's contact details need to be end dated, and some complicated logic needs to be applied to distinguish between mobile and landline numbers.
For a human to perform these checks, it is necessary to login to three different systems with one protected with a smart-card. The time taken to check each patient and make any changes is approximately seven minutes per transaction.
On a typical day, we will be checking an average of 120 patients and likely to achieve a hit rate of 10%. This will allow us to re-purpose potentially ten extra appointments per day.
This process will run outside of peak hours and will consume some spare bot capacity. Some objects used for our Urgent Treatment Centre were re-purposed to create this process. Go-live is set for today!