Reducing waiting times in audiology

Seeing how you can change the way things are done to make a big difference, has inspired Kent Community Health NHS Foundation Trust (KCHFT) audiologist Joy Nebo,

Last year (2019) Joy and her team took action after a huge influx of referrals for child hearing tests left them struggling to keep up with demand. Joy, a lead paediatric audiologist, looked at why it had happened and what could be done.

She implemented a series of changes and within just three months there was a massive improvement, with numbers on a waiting list more manageable, patient satisfaction up and referrals dealt with promptly and efficiently.

Inspired by this success, Joy now wants reductions in the reviews waiting lists. Wanting a planned approach, to measure results and to share her work, Joy is to launch a quality improvement (QI) project. She is working with trust QI advisor Kayleigh Hartshorn to get the project off the ground.

Joy said: “The improvement work I did before was not officially a QI project, but this is something I would like to do this time round.

“Previously, we faced a problem and we needed to deal with it. Last summer, we suddenly found we had around 900 referrals to deal with, in addition to our normal workload, which is usually around 300 to 400 referrals a month.

“It was a difficult time. We were being sent referrals, which were inappropriate and incomplete. There were inefficient admin processes. We had colleagues off on leave and morale was low.

“The team found there was an issue with processes and more education was needed for the teams that referred to us. This huge number of referrals was impossible for us to manage, on top of our other activity and waiting list.

“We started a triage system and came up with a new protocol. Patients were given a call as a first step. Where patients didn’t answer our call, we sent a letter asking them to contact us if they wanted an appointment.

“We found that not everyone wants or needs a face-to-face appointment. Some things can be dealt with on the phone. We’ve been doing a lot more over the phone during COVID-19, as the service was temporarily closed. It’s open again now, but this is something we will continue with.”

Joy and the head of service wanted the audiologists and the admin team to work more closely and so organised an away day to build team spirit, discuss issues and come up with an action plan. This included:

• introducing a patient tracker, to see where patients were in the system and to move them on in a timely way

• adopting a different approach to triaging and managing school health referrals

• new referrals forms and stricter acceptance criteria

• weekly conference calls to keep everyone up to date.

Joy plans to start her QI project this autumn (2020).

She said: “I want to review and reduce the waiting lists in a way which is safe and effective. I need to look at different ways of working to see if we can create more capacity.

“I want to make an improvement and make changes, which are not temporary, but permanent.”

The audiology department at KCHFT provides a hearing service to patients aged from birth to 16-years-old in west and north Kent, Swale and Medway.

  • Leadership and Management
  • Leadership and Management > Quality and Performance
  • Leadership and Management > Quality and Performance > QI
  • Leadership and Management > Service Design/Innovation
  • Leadership and Management > Service Design/Innovation > service improvements
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