An audit to analyze the three-week-wait pathway at department of otolaryngology, head and neck surgery, Sligo university hospital
DOI:
https://doi.org/10.18203/2320-6012.ijrms20230561Keywords:
Audit, Analysis, Pathway, Ear, Nose, Throat, Treating patientsAbstract
Background: Otolaryngology, head and neck surgery is an area of medicine concerned with diseases of the ear, nose, throat, head and neck regions. The Three-week wait pathway was introduced in Ireland as a way to improve access to specialist care for patients with symptoms suggestive of malignancy. The pathway allows patients to be seen by a specialist within three weeks of referral from their general practitioner. This study is aimed to study the three-week wait-pathway at the department of otolaryngology head and neck surgery, its functioning and how it can be applied in the department to reduce delays.
Methods: The quantitative and qualitative research was conducted during one year from January 2021 to December 2021.
Results: The results from the audit showed an average of 22 days on referral and an average of 70 days between the times a patient enters the facility and gets out after medical decision making is done. According to the audit, the three-week wait-pathway at department of otolaryngology Head and Neck surgery Sligo university hospital is effective. There are no significant delays in referrals or appointments, and patients are generally happy with the care they receive. The audit found good communication practices within the department, as measured by patient satisfaction scores.
Conclusions: This audit has looked at a variety of aspects of the pathway, including its effectiveness in diagnosing and treating patients, its impact on patient satisfaction, and its cost-effectiveness. The evidence suggests that the three-week wait pathway is an effective way to improve patient care and outcomes. Some quality improvement strategies would be necessary to optimize patient flow and clinical efficiency.
Metrics
References
Hawary AM, Warburton HE, Brough RJ, Collins GN, Brown SC, O'Reilly PH, Adeyoju AA. The '2-week wait' rule for referrals for suspected urological cancers--urgent need for refinement of criteria. Ann R Coll Surg Engl. 2008;90(6):517-22.
Rebecca S, Steven EO, Geoff H, Victoria A, Philip M, Edward B, et al. A cohort study of patients referred on the two week wait pathway. Cancer Epidemiol. 2019;63:23-9.
Meechan D, Gildea C, Hollingworth L, Richards MA, Riley D, Rubin G. Variation in use of the 2-week referral pathway for suspected cancer: a cross-sectional analysis. Br J Gen Pract. 2012;62(602):e590-7.
Carol C, Saira H. Organizational workflow and its impact on work quality. In: patient safety and quality: an evidence-based handbook for nurses. Rockville (MD): Agency for Healthcare Research and Quality (US); 2008.
Prakash B. Patient satisfaction. J Cutan Aesthet Surg. 2010;3(3):151-5.
Jones R, Rubin G, Hungin P. Is the two week rule for cancer referrals working? BMJ. 2001;322(7302):1555-6.
Katiri R, Sivan N, Noone A, Farrell E, McLoughlin L, Lang B, O'Donnell B, Kieran SM. Outcomes from 7 years of a direct to audiology referral pathway. Ir J Med Sci. 2022;32:1-7.
Sarkar S, Seshadri D. Conducting record review studies in clinical practice. J Clin Diagn Res. 2014;8(9):JG01-4.
Jamshed S. Qualitative research method-interviewing and observation. J Basic Clin Pharm. 2014;5(4):87-8.
Guidance for audiologists: onward referral of adults with hearing difficulty directly referred to audiology services. Available at: https://www.baaudiology.org/ app/. Accessed on 20 November 2022.
Medical Definition of Histology. Available at: https://www.medicinenet.com/histology/definition.htm. Accessed on 20 November 2022.
Greenwood-Lee J, Jewett L, Woodhouse L, Marshall DA. A categorisation of problems and solutions to improve patient referrals from primary to specialty care. BMC Health Serv Res. 2018;18(1):986.
Jahan M, Bartholomeuz T, Milburn N, Rogers V, Sibbering M, Robertson J. Transforming the 2-week wait (2WW) pathway: management of breast pain in primary care. BMJ Open Qual. 2022;11(1):e001634.
Recommended procedure: pure-tone air-conduction and bone-conduction threshold audiometry with and without masking. Available at: https://www.thebsa. org.uk/resources/pure-tone-air-bone-conduction-threshold-audiometry-without-masking/. Accessed on 20 November 2022.
Practice guidance: adult rehabilitation common principles in audiology services. Available at: https://www.thebsa.org.uk/resources/common-principles-rehabilitation-adults-audiology-services/. Accessed on 20 November 2022.