Service pressure in diagnostic ultrasound: “doing more” is not the answer. Improving efficiency whilst protecting sonographers’ wellbeing
By Morag Stout, NHS Education Scotland
Objective
To modernise administration processes in imaging departments to minimise “did not attend” (DNA) rates so as to maximise efficiency whilst avoiding the practice of overfilling ultrasound lists.
Method
Patient focused booking commenced in Ultrasound in January 2023. Patients receive an invitation to call to arrange an appointment within 72 hours. In March 2023, two questions were added to the invitation letter to avoid unnecessary scanning and/or duplication of work. Patients were asked to inform administration staff if they had already had a scan (ultrasound or other modality) or had surgery since the original request was submitted.
A survey was developed and sent to 14 Health Boards to consider administration processes around outpatient ultrasound booking and their associated DNA rates. Information around use of text confirmation(s), patient focused booking and short notice cancellation lists was collected and correlated with DNA rates.
Results
Introduction of patient focused booking in January 2023 showed DNA rates to reduce from 6.6% in September 2022 to 4.8% in February 2023. Introduction of two questions regarding interim imaging and/or surgery in March 2023 resulted in DNA rates reducing to 3.8% in May 2023. 11/14 boards responded to the survey. One board used patient focused booking and five used text reminders. Four used a short notice cancellation list. DNA rates varied from < 4% to 12% with an average rate of 7.3%. A clear association was identified between lower DNA rates and use of text reminders. However, this was strongly evident when coupled with patient focused booking.