Until recently, patients in Mamawetan Churchill River Health Region were waiting a long time, on an ever-growing waiting list, to get in to see a dietitian.
As part of a Rapid Process Improvement Workshop (RPIW) held last November, staff members and a patient worked together to streamline the process to review referrals, book appointments and educate clients in order to reduce the time it takes for a client to see the dietitian at the La Ronge Health Centre.
Due to a variety of factors, including out-of-date contact information or a lack of contact information, people in the region were waiting anywhere from 15 to 405 days to have an appointment booked. Compounding the problem was the fact that 33 per cent of the people who did get an appointment didn’t show up.
Changes were made in the electronic medical record (EMR) to prompt the provider to verify the client’s current contact information to ensure that the most up-to-date information is used when trying to contact clients. This was also supported by the development of standard work and a communication plan to referring providers. Other changes that were made in the EMR ensured that both the dietitian and the receptionist/office assistant at the La Ronge Health Centre had access to the dietitian’s task list. This change means that rather than relying on the dietitian to prepare and provide the receptionist with a paper schedule of appointments monthly, the receptionist is now able to check the task list daily and call clients immediately to schedule appointments. This means clients are not waiting up to one month for an initial call to book an appointment.
The changes appear to be working smoothly. The client is called by the receptionist within two days of the referral from the provider and is offered the first available appointment, which is usually within the same week as the call. Before the changes, 29 people were waiting more than 30 days for the initial offer of an appointment. At this point, there are no clients on the wait list and letters are being sent to clients who do not attend appointments. If clients can’t be reached after a set number of attempts, they are sent a letter with the dietitian’s contact information and are removed from the wait list until they call and request the service.
Further work was completed to set up a new standardized process that ensures clients who have missed multiple appointments are sent a letter encouraging them to contact the dietitian when they are ready to schedule and keep their appointment. They are then removed from the wait list until they are ready for services.
Communication between the dietitian and the community health receptionist is constant while this process is being implemented to ensure that the newly implemented procedures are working well. Besides shortening waits for clients who are ready to meet with a dietitian, the changes have also improved work processes for providers in the region.