1. Ultrasound DNA Reduction Presenter: Kathy Dryden Health Service: Auckland District Health Board Innovation Poster Session HRT1215 – Innovation Awards Sydney 11 th and 12 th Oct 2012 The Health Roundtable 2-2d_HRT1215-Session_DRYDEN_ADHB_NZ

2. Ultrasound DNA Reduction Definition Patient Did Not Arrives (DNA’s) have an impact on our patients, our staff and productivity. The Radiology Team at Auckland District Health Board have changed the way they interact with patients to reduce DNA’s. Our goal To reduce the number of people not arriving for appointments by 50% and therefore reduce waiting times. Problem definition and Baseline In April 2010 the waiting time for General Practitioner (GP) referred Ultrasound was between 7 and 8 months and more than 20% of Ultrasound GP patients did not arrive for their appointment. This meant that many patients were not getting necessary imaging and that there were gaps in the ultrasound work lists due to patients not arriving. Methodology and approach We asked patients who did not arrive for appointments why, they told us: they did not receive an appointment letter (39%) they forgot about the appointment or were confused with another appointment (20%) they no longer required the Ultrasound (14%) The team identified the root causes behind these issues and gathered information to support them. Solutions were developed and trialed for a specific group of patients before being rolled out. Solutions The project team researched what groups within Auckland District Health Board and other Radiology groups had done. The key to solving the issues was changing how we interact with patients. Patient Focused Bookings A new process was piloted for Ultrasound (Priority F) patients at Greenlane. This was to solve issues around patients not receiving letters or no longer requiring examination. The process provides patients more choice of appointment times, and also returns the referrals to GP’s for patients who could not be contacted so the GP can follow up with them. Results There have been some impressive results since the implementation of the new booking system. Waiting times for GP Ultrasound appointments have reduced from 8 months to none. GP referred patients using the new process that do not arrive for their appointment has reduced from 22% to 13% by using patient focused bookings. 75% of Priority F Ultrasound Patients are now seen within the 12 week target (previously under 20%). 30% of GP invite letters have been returned to the GP, as the patient was not able to be contacted, or no longer required the appointment, so the GP can follow up with the patient. The patient focused booking process has now been extended across other Radiology modalities to give patients more choice and reduce DNA’s. The Ultrasound DNA Reduction Project Team Lessons Learnt Getting the voice of the patient was key to understanding the causes of patient DNAs. patient safety economic sustainability improved health status better quality care Our key result areas: engaged workforce Kathy Dryden, Auckland District Health Board (kathyd@adhb.govt.nz )