Reducing the Waiting List for New Referrals to the ENT Outpatient Department

Lengthy outpatient waiting lists are a global healthcare concern affecting most hospital specialities, including in Ireland. The result is a delay in treatment and suboptimal outcomes for newly referred patients. Simultaneously, patients requiring long-term follow-up care exist amid this overburdened system. Data collection showed that in December 2017, 3,944 patients were waiting for a first time appointment within the ENT service of a large urban teaching hospital in Dublin. Of these, 766 were waiting to be seen by just one consultant and a total of 399 were waiting for more than 52 weeks. Of the 882 patients who were seen by the consultant between January and December 2017, only 252 were new referrals. These figures highlight the large proportion of return patients attending ENT outpatient services. This quality improvement project plan concentrates on an effort to improve waiting times for new patients by the creation of a non-physician-led ‘microsuction clinic’, which aims to streamline patients requiring regular care within the ENT department. Quality improvement tools including a driver diagram and an Ishikawa diagram were used to establish the root of the problem. With guidance of the DMAIC framework, the anticipated result could be a 46% reduction in the number of patients waiting more than twelve months, within one year of the projects implementation. Simultaneously, return patients could benefit from improved continuity of care and faster access to outpatient follow-up appointments.