Health Systems – Influencing Policy
This case study highlights where grass roots engagement by researchers in the Department of Management Science influenced implementation and further development of government policy on how NHS patients are contacted and flow through outpatient services.
Who was involved?
The project focused on orthopaedic outpatient services, specifically on non-operative trauma patients who come through accident and emergency. This involved collaboration between The Scottish Government Quality and Efficiency Support Team (QuEST), the Glasgow Royal Infirmary (GRI) and the Department of Management Science. The aim was to provide evidence to support the roll out of a fracture redesign service across Scotland and the UK more widely.
What was involved?
A virtual fracture clinic was the main part of the redesign where patients are assessed without them needing to attend in person. We successfully evaluated, cost effectiveness, resource efficiency and patient centred care as part of increasing the evidence base for the hospital’s model of fracture redesign. This was part of a suite of evidence where the hospital evaluated the clinical outcomes, looking at equitable, timely and safe aspects of the redesign.
How we helped?
This evaluation communicated and improved understanding of the process flows across multiple stakeholders, providing confirmation of the system pressure points and quantifying the baseline efficiencies and staff utilisation for a traditional fracture clinic in comparison to a virtual clinic. The fracture pathway redesign illustrated that innovation and ensuring the patient is at the centre of the change can be more efficient in terms of costs and utilising staff more efficiently.
What did we do?
Analytical methods were developed to investigate the redesign, obscure the myths and act as a translator between managers, government and clinicians. Visual statistical models were developed to drive engagement between managers and clinicians make sense of some of the barriers to adoption.
Future engagement
Future collaboration will explore how many times patients return after their initial face to face appointment by modelling patient inflow from operative trauma, primary care referrals and patients coming back for additional visits. This would help to identify and understand the pressures this places on outpatient services as a whole. There is also huge potential to look at redesign in other clinical areas using Glasgow Royal Infirmary as the testbed based on the relationships and teamwork that has developed as a result of this work.
