Improving outpatient capacity and patient flow

Wrightington, Wigan and Leigh NHS Trust

Longstanding problems with patient flow would need to be overcome in order to free up 2,800 new outpatient slots and achieve annual operating targets.

The challenge

Wrightington hospital has an orthopaedic centre of excellence, world renowned for specialist services of the highest quality. Yet, despite this outstanding clinical reputation there were real threats of closure facing the unit.

The problems lay in the shortcomings surrounding patient access to the service and the significant impact that poor pathway management was having on financial performance. Despite many previous internal and external attempts to improve, the problems remained, resulting in inappropriate processes and poor resource utilisation.

Unipart were asked to find a different way of engaging the staff in overcoming these problems, in order to create a significant performance turnaround – to achieve annual theatre operating targets would need 2,800 new outpatient slots to be created. This would require improved patient flow and a big reduction in the lengthy waiting times for outpatient access.

How we helped

Our experience, from our own company, told us that a high degree of employee engagement would be the key to unlocking success, so our team spent the first month working closely with staff, at all levels, to identify the underlying issues.

Both management and local teams were working in silos with little personal accountability, while all staff had little confidence in their ability or impact when suggesting improvements for their own processes. The clinicians possessed a real sense of pride in the unit’s reputation but they too were becoming tired with the systems that were letting their service and their patients down. Given this context, a major priority was to bring the staff together and help develop team based problem solving.

With Unipart support, the clinical and operations teams now started working as one in order to identify the root causes of problems and then design their own solutions. For example, X-ray requests, which were being written on the day of an Outpatient appointment, were contributing to the longer waiting times for patients. This was replaced by a new system which identified patients’ needs in advance and provided them with a specific X-Ray appointment time two weeks before their visit, resulting in better forward planning and less waiting time.

In addition to resolving process problems such as these, the team worked to re-design the layout of the department and change the way space was used to gain extra capacity.

The results

The programme was successful in finally overcoming the longstanding problems and delivering significant increases in performance:

  • A considerable improvement in the patient experience with a 54% reduction in waiting times and a 35% reduction in access times
  • A 35% increase in activity providing £1m of additional revenue