Outpatients

Outpatient Departments (OPD) stand as one of the largest sectors within a hospital, often catering to thousands of patients daily, the magnitude varying with the size of the Trust. This domain represents a pivotal revenue generator while simultaneously incurring substantial overheads.

Despite the differences in specialties, the challenges pertaining to productivity within OPDs tend to exhibit remarkable uniformity. These challenges encompass underutilised time slots, unwarranted supplementary expenditures, and outdated clinic templates.

Meridian’s approach entails collaborating closely with Trusts to ensure that Outpatient Departments operate at full capacity, aligning with the specific demand of each specialty.

Our intervention extends to the implementation of robust reporting systems, furnishing managers with actionable insights. These insights enable informed resource allocation decisions and facilitate the approval of additional capacity, all contributing to more effective resource management and enhanced operational efficiency. This holistic approach not only drives financial viability but also elevates the quality of care delivered within the Outpatient Departments.

Case Studies: Outpatients

Outpatient Department Improvement Programme (North West England)

The clinic utilisation, across all observed disciplines was 49% against a national expectation of 85%. There was a high proportion of missing medical records, and out of all observed patients only 15% were seen at their appointed time.

Outpatient Department Improvement Programme

There was a laisse-faire attitude to late starts of 44% and late finishes of 31% with no quantification of the effect on staff rostering, the accumulated time off in lieu and clinic session utilisation of only 77% whilst the Trust was also running waiting list initiatives.

Acute Hospital: Outpatient Department Improvement

There was no process in place to measure actual utilisation of core capacity. In addition, the impact to patient waiting times was significant, leading to an obvious culture of ‘waiting’, low staff morale and poor quality of service.

Productivity Programme in the Musculoskeletal Outpatient Department

The study found opportunities to standardise and fix therapists’ clinic templates, increase visibility of the referral waiting lists at all points in the patient flow and develop management control on capacity and demand across the teams.

Theatres, Outpatients & Radiology Improvement Programme

The analysis was a three-week long study, with a total of 35 days being used. The historic performance and management control systems showed a lack of control of planned and actual activity, expectation and performance.

Ophthalmology Improvement Programme

The service was under enormous pressure due to excessive demand, with steadily increasing waiting lists and consistent breaching against internal targets.

Community Paediatrics (Outpatients) and Diana Services Improvement Programme

The service suffered from a lack of performance data, clear targets and expectations, planning standards and a systematic and robust way of allocating work ensuring clinic maximisation as well as an effective follow up process.

Medical Capacity and Clinic Utilisation

Meridian undertook an analysis of sessional fulfilment, and planned verses actual activity levels of clinics, incorporating quantification of the volume of extra Waiting List Initiatives (WLIs) that had been carried out, with a view to repatriate waiting WLIs into core sessions.

Outpatient Improvement Programme (South East)

The internally driven processes and systems had been unable to impact upon the levels of performance. With an increasing demand of patient referrals and a shrinking cost envelope, a focus was required on the levels of slot utilisation.

Outpatient Department / Increased Slot Utilisation, Optimisation of Clinic Capacity and Increased Revenue

Action had been taken to cease additional spend on ‘extra’ outpatient capacity, but there was no system to assess the impact. Similarly, there was no means to quantify or review the utilisation of the resources or clinic slots and sessions.

Medical Capacity Planning

The processes implemented provided Medicine Division management control over the proactive governance of the booking teams, rostering and operational variances, as well as visibility on a daily basis of individual and team performance.

Medical Outpatient Clinics Improvement Programme

The studies showed that whilst most specialties had the capacity to extend their clinic templates by increasing the number of patients seen, other specialities evidenced low demand and an opportunity to reduce underutilised clinics.

Case Studies: Outpatients

References