Improving outpatient waiting times in Clinical Haematology Services

The Clinical Haematology service at Gloucestershire Royal Hospital routinely ran late, with patients often being seen 30 to 60 minutes after their appointment time. This was highly frustrating for both patients and staff. Due to a lack of consensus over the causes of the problem, it had continued for some time.

Staff decided to resolve the issue, and agreed on a project aim of improving patient flow in their Haematology clinics by reducing waiting times over a period of 10 months.

They began by drafting a driver diagram, which allowed them to establish the key drivers of the issue. After generating change ideas and analysing baseline data on wait times within the outpatient clinic, the team decided to use Plan-Do-Study-Act cycles (PDSA) to test and refine their change ideas. Using PDSA methodology allowed them to measure the effect of each change separately.

The first PDSA cycle involved updating appointment letters to instruct patients to attend before their appointment time in order to have their bloods taken before consultation. The second PDSA cycle established a separate clinic for patients with myeloma, who were found to be the most likely to over-run their appointment times.

The changes were successful, with patients giving positive verbal feedback and responses from the Friends and Family Test showing a decline in comments about long clinic waits. The team found that it was crucial to involve both clinical and non-clinical staff in the process. They plan to move forward with these changes and consider disease-specific clinics for other conditions as well. You can read more about their work here.