New over-the-phone triage improves paediatric waiting times

The introduction of a new model for referring children to occupational therapy and physiotherapy in Cwm Taf University Health Board has helped to improve access to services.

The Health Board’s paediatric therapies department recently benefited from a project funded by Health Education and Improvement Wales (HEIW).

The team embraced the opportunity to develop a new model of change to deliver training across the multi-disciplinary team and put in place new ways of working to manage ongoing demand and capacity challenges.

Focus was placed on the referrals of children and young people into the services to make sure correct referrals were being accepted onto the waiting list and identify where the biggest impact could be made for those most in need.

Paediatric physiotherapy initiated the project by introducing a telephone triage process and developing supporting paperwork which was then rolled out to other teams.  Previously, when a referral was received into the department, the patient would be put on a waiting list for around 14 weeks and would then be seen in order of priority and date of referral.

But the team often found the selected service wasn’t always best placed to address the need and another health or social service would be of more benefit, causing further delay for the child.

By introducing the new  model, a qualified therapist receives the referral and triages the patient by speaking to the appropriate person over the phone.  This can be the parent, guardian or sometimes the teacher.

The telephone assessment can take around 45 minutes, and although this can be time consuming, it gives the team a full history of the young person’s strengths and difficulties as well as an insight into what outcomes and expectations are hoped to be achieved from the service.

Since its introduction, the team has seen greatly improved outcomes for  patients, as well as families, and the new way of working has been a real asset to the working relationships of the team and the service.

Sarah Lewis-Simms, deputy head occupational therapist, said: “The referral information we receive and the concerns of the patient and their carer can sometimes be quite different.

“As a result of this project our approach has changed and we are having clearer discussions with the patient and their family to find out what is of most concern and the impact.

“We will also know after the telephone assessment if the child/young person has needs that we can address immediately with advice and strategies or if we can signpost to alternative services that may help answer any other questions they may have before they attend their next appointment.

“When the child/young person comes in for their appointment with the therapist the quality of the appointment is much better as we already have a full history of strengths and needs.”

As well as there being an improved service for the children/young people and their families the change means that the service runs much more efficiently and effectively with the resources available.

Donna Morris, principle paediatric physiotherapist, said: “Since we have put in place the triage service we have seen increased collaboration and co-production with the children, young people and families of Cwm Taf to make quality changes”.



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