Clinical Pathway & Process Restructuring
Our healthcare client faced significant challenges due to unclear triaging processes and poorly defined clinical pathways, which often resulted in referrals being placed on incorrect waitlists.
This inefficiency caused extended wait times for patients and made it nearly impossible to track the volume of waiters or identify priority cases. Additionally, the administrative and clinical workflows involved too many hand-offs between teams, slowing down processing and reducing overall efficiency. We were tasked with streamlining these processes to reduce delays and enhance reporting accuracy.
The Challenge
Our client’s referral system was burdened by a lack of clear guidance on triaging patients, leading to many being placed on incorrect and poorly-defined pathways. This issue caused delays in treatment, particularly for children, as referrals were often misdirected or re-assigned multiple times. In addition, the complex and disjointed administrative processes, with frequent hand-offs between teams, extended the processing times for each referral, contributing to a backlog of cases. The existing pathway structure also made it difficult to accurately track the number of patients waiting and to identify high-priority cases, especially those approaching target deadlines.
Our Approach
To address these challenges, we took a structured, comprehensive approach:
1. As-Is Business Process Mapping:
• We conducted a thorough analysis of the current administrative and clinical workflows, mapping out each step in the referral and triaging process.
• Our analysis revealed unnecessary touchpoints across multiple teams, which contributed to delays. By eliminating these inefficiencies, we designed a streamlined process with fewer hand-offs, ensuring faster referral processing.
2. Standard Operating Procedures (SOPs) for Accurate Triage:
• We developed clear and concise Standard Operating Procedures to guide staff in triaging patients accurately. These SOPs helped ensure that children were placed on the correct waitlist at the first point of contact, reducing the time spent on misdirected referrals.
• The SOPs empowered staff to make more informed decisions, ensuring that clinical pathways were aligned with patient needs from the outset.
3. Creation of Defined Pathways:
• We restructured the existing pathways, creating five distinct, clearly defined clinical pathways. These pathways helped streamline the movement of patients through the system, reducing the likelihood of delays due to incorrect placements.
• Alongside this, we redesigned the information collected at the referral stage to support more accurate reporting. This allowed for real-time visibility of the number of patients on each pathway, tracking growth trends, and identifying priority cases.
4. Improved Reporting and Compliance:
• We implemented a reporting structure that provided greater clarity on the number of waiters, pathway growth over time, and easily flagged patients nearing government target deadlines. This improved oversight allowed the client to allocate resources more effectively and ensure compliance with government standards.
Key Results and Deliverables
• Reduced wait times: By eliminating unnecessary hand-offs and streamlining the triaging process, we significantly reduced wait times for children being placed on the correct pathway.
• Enhanced accuracy in triaging: With the new SOPs in place, the rate of incorrect referrals decreased, ensuring that patients were placed on the correct pathway from the start.
• Clear pathway structure: The six well-defined pathways improved both operational efficiency and the clarity of the patient journey, reducing confusion for both staff and patients.
• Accurate reporting: Our restructuring allowed the client to track waitlist volumes, growth trends, and easily identify priority patients and those close to breaching targets. This real-time data improved resource allocation and compliance management.
Conclusion
Our clinical pathway and process restructuring project successfully addressed the client’s need for more efficient and accurate referral management. By reducing hand-offs, creating clear pathways, and improving the accuracy of triaging, we helped reduce wait times and improved the overall patient experience. Our approach also provided the client with the tools they needed to better manage their waitlists, prioritise urgent cases, and remain compliant with government standards.