A one-stop clinic improvement project for postmenopausal bleeding in NHS Forth Valley.

Area of Science:

• Gynaecology
• Healthcare Management
• Quality Improvement

Background:

• Postmenopausal bleeding (PMB) referrals caused significant delays in general gynaecology outpatient clinics.
• Concerns about extended waiting times from referral to diagnosis prompted this project.
• The project addressed a bottleneck in patient care within NHS Forth Valley.

Purpose of the Study:

• To evaluate the effectiveness of a process redesign aimed at shortening the waiting time for PMB diagnosis.
• To test a new model for managing PMB referrals and reduce diagnostic delays.

Main Methods:

• Implemented Active Clinical Referral Triage (ACRT) and a one-stop clinic model.
• Utilized quality improvement methodologies, including process mapping and data collection.
• Employed Plan-Do-Study-Act (PDSA) cycles to iteratively test and refine the one-stop clinic concept.

Main Results:

• Qualitative feedback indicated a strong patient preference for the one-stop clinic.
• Preliminary quantitative data suggested a reduction in waiting times for PMB referrals.
• The new process demonstrated improved efficiency in patient management.

Conclusions:

• A one-stop clinic effectively streamlined the diagnostic pathway for PMB and unscheduled bleeding on hormone replacement therapy (HRT).
• The implemented process change successfully reduced waiting times between referral and diagnosis.
• The findings highlight the potential for significant waiting time reductions in this clinical pathway.