Melissa Blow and Carlie Griffiths
Aneurin Bevan University Health Board
Project Background:
Lower limb wounds occur in approximately 1.5% of the population across the whole healthcare system.
Associated cost of wounds are estimated to be £6 billion of the National NHS spend.
Contributing factors associated with lower limb wounds identified within Aneurin Bevan University Health Board:
- Multiple referral points for specialist review, GPs’, community services unsure of who and where to refer to, a ‘scatter gun of referral and duplication.’
- A predominantly paper based process with inability to track referral or patients through their care journey. No whole system defined referral or discharge pathways.
- Required assurance of meeting NICE guidelines for lower limb wounds, in particular triage of diabetic foot ulcer referrals within 24hrs.
Project Objectives:
- Work alongside colleagues and develop an agreed referral pathway.
- Single portal of referral for lower limb wounds to streamline and meet NICE guidance for triage within 24hrs. Increase visibility and outcome of expert assessment by specialist teams, to move from paper to electronic records of input.
- Improve referral route for patients to be seen by the right people at the right time.
Project Outcomes:
Agreed Pathway and paperwork were agreed and implemented by all stakeholders.
Data Capture. The project has captured data on all referrals through the electronic system and can provide assurance that we are meeting NICE guidelines on time to triage within 24hrs. The number of referrals and burden of chronic wounds can also be estimated, it was much higher than anticipated.
Centralised system and standardisation of paperwork and point of contact. Person centred , having a lower limb portal and call centre , offers the opportunity for advice and remote escalation with electronic records.
Project Impact:
- Enabled opportunity to audit and monitor referrals across the whole system.
- Breaking down barriers working across specialities.
- Developed and implemented a single standard process for referral. A ‘one door’ approach for ABUHB patients with lower limb wounds was successfully launched .
- Moved from paper based to electronic triage system that can be monitored and evidenced against guidelines standards.
