Abstract
Introduction - The POPS service (SOPAS) in Morriston Hospital receives over 300 referrals a year. However, many of these referrals did not meet service criteria. Inefficient direction of referrals has a negative impact on service efficiency and can result in poor patient experience and outcomes. This is a quality improvement initiative to increase the quality and suitability of referrals made to the service.
Aim - To implement a referral system able to offer safe, rapid assessment for surgical patients who would benefit from geriatrician-led intervention.
Method - We developed a list of criteria for referral to the service and included 47 referrals over a two-month-span for analysis. Two PDSA improvement cycles were then performed. The first cycle involved implementation of an automatic email response to referrals as they came in addressing the main safety concerns highlighted in the analysis. The second cycle involved setting up a new referral process via an online form to provide structure and prompts for key information to improve the content of referrals along with collecting service data prospectively.
Results - Prior to invention, many referrals missed key information. Almost a quarter of referrals were from specialties that POPS does not accept and some requested emergency reviews not appropriate for this service. The first improvement cycle effectively decreased the number of inappropriate or unsafe referrals according to clinician feedback. With the second cycle we hope to improve the quality and content of referrals as we introduce our referral form.
Conclusion - The new system improved the suitability and quality of referrals to POPS. By reducing inappropriate referrals to POPS, eligible patients could be seen by the right service in a timely manner, improving outcomes. We saw that a proforma is an effective way to improve referral content, and that an online form is useful in making an accessible referral process.