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Related Experiment Videos

Using 'Active Signposting' to streamline general practitioner workload in two London-based practices.

Faisal Siddiqui1, Baljinder Sidhu1, Mohammad Aumran Tahir2

  • 1Faculty of Medicine, St. George's University of London, London, UK.

BMJ Open Quality
|February 17, 2018
PubMed
Summary

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General practitioners (GPs) are overwhelmed by patient demand. This study found that active signposting by reception staff significantly reduced possibly avoidable telephone consultations, increasing essential GP time and improving patient access to care.

Area of Science:

  • Primary Health Care
  • Quality Improvement in Healthcare
  • Health Services Research

Background:

  • General practice faces significant pressure from increasing patient demand and financial constraints.
  • Telephone consultations (TCs) are utilized to alleviate pressure, but many involve general practitioners (GPs) when alternative solutions exist.
  • Identifying and reducing non-essential GP TCs is crucial for optimizing primary care resources.

Purpose of the Study:

  • To evaluate the nature of TCs in general practice and determine the proportion of consultations that could have been managed without GP involvement.
  • To assess the effectiveness of an intervention involving active signposting by reception staff to reduce 'possibly avoidable' TCs.

Main Methods:

  • A quality improvement project (QIP) was conducted across two general practices.
Keywords:
cost-effectivenessgeneral practicelean managementpatient satisfactionquality improvement

Related Experiment Videos

  • A retrospective analysis established baseline data for 'possibly avoidable' TCs.
  • Reception staff were trained to actively signpost patients to allied healthcare professionals or alternative services when a GP was not essential.

    • Main Results:

    • Following the intervention and two Plan-Do-Study-Act (PDSA) cycles, the proportion of 'essential' TCs increased significantly.
    • Essential consultations rose from baseline figures of 28.6% and 27.3% to 82.6% and 71.4% in the two practices, respectively.
    • This indicates a substantial reduction in 'possibly avoidable' TCs.

    Conclusions:

    • Active signposting by reception staff is an effective strategy to reduce non-essential telephone consultations in general practice.
    • This intervention optimizes GP time, enhances cost-effectiveness, and improves patient access to appropriate care services.
    • Such strategies are vital for managing the current demands on primary care systems.