As with many medical specialties in Ireland, getting an appointment with an ENT consultant is difficult to secure. At the start of this project, there were a large number of patients waiting to be seen by ENT specialists at the Mater Hospital.
Almost all available appointment slots were being used for urgent cases which meant that wait times for those with routine conditions had become excessive, despite the impact of these conditions on quality of life for patients. Staff in the ENT service felt stressed and overwhelmed with trying to provide a service under these conditions.
The team were aware that many of their processes were labour intensive and largely paper based. However, due to their heavy clinical workload, it was not possible to stand back, see the whole picture and tackle the problem in
Mater Transformation worked closely with the ENT multidisciplinary team to carry out a full system review. This began with a period of data collection and extensive mapping of all the existing processes. The team then came together in a week-long ‘Value Stream Analysis’ event, to make sense of this data and to collaboratively build a roadmap for change.
The first task was to streamline the processes of referral, triage and scheduling as well as to digitise paper processes where possible. These gains helped to give some time back to the team and enabled a more clear picture of actual demand and capacity for each of the sub specialties — Rhinology, Otology and Head and Neck.
New ways of delivering care were then explored. For example, could patients with voice disorders have direct access to Speech and Language Therapy rather than requiring that they wait to see the consultant first?