Reducing the time waited from referral to consultant appointment in the Sleep Apnoea Clinic to less than 11 weeks

Quality Improvement Poster Download

Background & Problem

Sleep apnoea is a condition which finds the sufferer having problems breathing overnight due to their airway collapsing. In order to resume breathing they are forced to wake up and this can occur 5-100 times an hour. Imagine being woken every minute through a whole night and then trying to undertake all your normal daytime activities without feeling tired, or even falling asleep.

If this was you would you want to wait 6 months to have your condition diagnosed and treated?

No we didn’t think this was acceptable either but due to the increased publicity surrounding this condition we were facing an unprecedented number of referrals and the service was unable to cope.

Aim

Reducing the time waited from referral to consultant appointment in the Sleep Apnoea Clinic to less than 11 weeks.

Method

In order to change the situation with no additional resources all interested parties looked at the patient pathway to see if we could improve it and as a result reduce the wait for patients. The outcome was a radical approach and one that should significantly improve the patient experience.

We looked at four areas of the pathway that we felt failed:

• Quality of referral from the GP
• Failure to attend rate for the consultant clinics
• Failure to attend rate for sleep studies
• The time taken from receiving the GP referral to the patient seeing a consultant

Changes that we looked to make were:

• Introduce a GP referral tool to assist GPs in decision making
• A patient questionnaire prior to the sleep study
• Introduction of the role of ‘Consultant of the week’
• A sleep MDT
• Discharging of patients with a normal sleep study

The impact of each of these changes was checked using a plan, do, study, act (PDSA) cycle and we have run these on a number of occasions to test the results.

Results

Due to the size and complexity of the entire project and the loss of key personnel certain changes are ready to be implemented but cannot be introduced on their own due to the impact it will have on other parts of the process.