UCLH Productive Outpatients

Paediatric Allergy Service - Full Programme

PAEDIATRIC OUTPATIENTS ALLERGY
Allergy clinics run once a week, which consists of
three clinics. The patient pathway is complex as the
patient sees a range of healthcare professionals a
number of times, a typical pathway would involve
seeing a Consultant twice, a Nurse twice, and a
Dietician. As the skin prick tests can be
uncomfortable, the service is also supported by our
fantastic play specialist. The service originally saw 21
patients per clinic and templates for each clinic were
different. The allergy service is a busy and popular
service and we aimed to improve the patient and staff
experience.
DRIVERS FOR CHANGE
Allergy in children becoming more prevalent
Stressed capacity - Overbookings
Complex pathway in clinic
Mid clinic rush
Patients expectations not met
Long Waits in Outpatients
Non-compliant with Gold standard guidance
(*RCPCH/NICE/BSACI) for dietician
involvement
Minimal patient information available
Long waiting list for follow ups 7months

AIM

To improve the efficiency of the allergy

service from referral to treatment in
Paediatric Outpatients, including the
patient experience.

OUTCOMES

WHAT DID STAFF HAVE TO SAY?

Before

Changes made

After

Maximum of 21 patients seen in

clinic.

We tracked patients attending

clinic over the course of two
months.
Based on the results we amended
clinic template to improve nurse
utilisation. Five patients seen at
9am.

-Nurses time better utilised, see

two follow up patients at 9am
-Maximum of 24 patients per clinic

Paediatric Outpatients is splits

across two areas. Three rooms
were on one side and the
remaining two on the other. This
resulted in waste walking to and
from rooms and unnecessary
delays.

Co located all clinic rooms, based

on information from spaghetti
diagram.

-Reduced waste
-Less moving for patients
-Easier sharing of information

We had limited patient information

about allergies and wanted
parents to take away information,
helping signpost to useful
organisations.

Developed / updated patient

information and developed a new
webpage about the allergy service

-Attract more patients to choose

UCLH
-Provide reliable, quality condition
specific information
- Provides a friendly and
welcoming service

Children reported they felt worried

before the skin prick tests and
found them upsetting and
uncomfortable. It was challenging
for the play specialist to work with
every child that visits clinic.

Developed at themed,
educational, sticker charts

-Improved patient and parent

satisfaction
-Good distraction technique
-Educational tool, as record
allergens

Lack of pre clinic patient

information meant that people
arrived and were unclear of the
process or how long they would be
here for.

Created pre clinic proformas and

updated pre clinic letter

Nurses waited for half an hour

until they saw first patient

-Important information gathered

prior to consultation, saving time
- Patients expectations met during
their visit

Insert staff of clinics

The reorganisation
commentsand we
is more productive
were seen very quickly very
impressed, efficient, keep up
the good work Parent

As a team building
exercise it has been
remarkable
Consultant

NEXT STEPS June 2013

Joined working with RNTNE
Food Challenges in Outpatients
Telephone follow ups
Additional Dietician Services to meet
demand
Nurse led follow up clinics
Share learning with other specialties
and at National conferences
CONTACT DETAILS
Lucie Clough
Paediatric Outpatient Manager
Ext 76539
Lucie.clough@uclh.nhs.uk
http://youtu.be/61qWkyi6BYQ
March 2013 Wave 8