Student: Annelise Basevi
Supervisors: Dr Andrew Richardson, Professor Les Toop, Dr Paul Abernethy
Sponsor: Pegasus Health (Charitable) Ltd
The 24 hour surgery was created 25 years ago as an after-hours service for General Practitioners (GPs). Since then it has grown to provide extra services for more complex patients. It is the only place in Christchurch, apart from the Emergency Department, that is able to provide 24 hour medical care, 7 days a week. There are over 320 GPs in Christchurch who are enrolled with the surgery and recommend the after-hours services. This means there are 380,000 patients that can use the healthcare provided at the 24 Hour Surgery. Patient numbers at the surgery can be very unpredictable which may result in long waiting times. The focus of my summer studentship is working with a project team at the 24 Hour Surgery to try and improve patient flow within the surgery.
Now the 24 Hour Surgery has such a broad range of services, the patients who just need a quick doctor consult arrive at reception mixed together with the patients that need complex consults. These patients are triaged as non-urgent. They spend a long time waiting yet they only need to spend a short amount of time with the doctor. What we are doing is trying to identify patients who will only require a short consult. We will then stream them separately from the other patients arriving at the surgery. This patient stream will be called the “Green Stream”. The focus of the Green Stream will be to try and move these patients in and out of the surgery more quickly.
The Green Stream is made up of a doctor, nurse and healthcare assistant (HCA) working as a team. Patients arrive at reception and are then seen by the triage nurse. Patients likely to have a quick consult with the doctor are put into the Green Stream by the nurse. The patients are then seen by a HCA who does some basic tests before seeing the Green Stream doctor.
The Green Stream pilot began on Saturday the 24th of November and has been run every weekend since. It was also run most days over the Christmas and New Year period. Data was collected and analysed each week allowing us to make changes as needed.
Overall the project was a success. The average time in facility for a Green Stream patient was 35 minutes. The feedback collected from staff and patients was generally positive. The total time in facility for all patients at the 24 hour surgery was reduced by 10% during the time the project was running. This suggests that all patients, not just those in the Green Stream, had shorter waiting times because of an improvement in patient flow.
The results of this study show that the Green Stream is a success however it has been suggested that that the full potential of the project has not been reached. Further analysis of the Green Stream is recommended before the 24 Hour Surgery permanently adopts the project as a tool to improve patient flow.