A one-stop clinic improvement project for postmenopausal bleeding in NHS Forth Valley.

Abstract

Referrals for postmenopausal bleeding (PMB) were creating a pressure point within a general gynaecology outpatient clinic in NHS Forth Valley (NHSFV) in Scotland. This project originated in concerns around delays in time from referral to diagnosis as a result of this pressure point. The aim of this project was to test the efficiency of a process change which reduced waiting time from referral to diagnosis for patients with PMB. Use Active Clinical Referral Triage (ACRT) and a one-stop clinic to reduce waiting lists. Quality improvement methods including data collection and process mapping were used to understand the current system. Cycles of the Plan-Do-Study-Act (PDSA) tool were applied to test the concept of introducing a one-stop clinic for PMB. Qualitative data gathered during the project showed that patients preferred the one-stop clinic. Limited quantitative data indicated the one-stop clinic design reduced PMB referral waiting time for patients. Our aim was to streamline a process to reduce waiting time between referral and diagnosis for patients with PMB. This was achieved by the creation of a one-stop clinic for PMB/unscheduled bleeding on HRT (hormone replacement therapy) patients. The work to date has highlighted the efficiency of the new process and ultimately suggests the potential for a reduction in waiting times in this pathway.