Successfully reforming orthopaedic outpatients

Area of Science:

• Health services research
• Orthopaedic surgery
• Patient management

Background:

• Increasing referral volumes and inefficient processes led to long wait times and poor resource utilization in orthopaedic outpatient services.
• High 'Did Not Attend' (DNA) rates and underutilization of conservative treatments before surgical referral were significant challenges.

Purpose of the Study:

• To evaluate the impact of a comprehensive reform of orthopaedic outpatient services at Barwon Health.
• To improve referral management, reduce waiting times, decrease DNA rates, and enhance the utilization of conservative therapies.

Main Methods:

• Implementation of strategies including waiting list audits, triage guidelines, physiotherapy-led clinics, a DNA policy, an orthopaedic lead nurse, and a patient-focused booking system.
• Systematic review of referral data, appointment wait times, and DNA rates before and after reform implementation.

Main Results:

• A 66% reduction in the number of patients waiting for their first orthopaedic appointment.
• An 87% reduction in waiting time from referral to first appointment.
• A 10% reduction in new patient 'Did Not Attend' (DNA) rates and improved referral management.

Conclusions:

• The implemented reforms successfully addressed key issues in orthopaedic outpatient services, leading to improved patient flow and timely access to care.
• Earlier access to conservative treatments and more efficient processes were achieved, enhancing the overall patient experience and resource management.