Authors (including presenting author) :
Cheung SMM
Affiliation :
(1)Speech Therapy Department, Pok Oi Hospital, (2)Speech Therapy Department, Tuen Mun Hospital, (3)Speech Therapy Department, Tin Shui Wai Hospital
Introduction :
HAHO Guidebook on Key Performance Indicators 2021/22 provides a clear instruction that patients should be assessed on the basis of the urgency of their clinical conditions when they are referred to speech therapy outpatient services. Patient referrals are classified into P1 (urgent), P2 (semi-urgent), and Routine (non-urgent) categories. The aim of the prioritization is to ensure that appropriate treatment, with the limited resource available, is given to patients within the appropriate time period in consideration with their varying degrees of clinical urgency.
Patients should be initially screened and triaged once the referrals are received by the outpatient clinic. They would be triaged according to the common reference of the speech therapy outpatient triage category (latest version as in Mar2022). All referrals must receive a final triage by a senior speech therapist or a designated experienced speech therapist within 5 working days after the first triage. Appointments should be rescheduled accordingly whenever indicated.
Objectives :
1.To ensure good practice in out-patient new case appointment arrangement by timely and appropriate triage according to clinical urgency
2.To review the compliance of the triage workflow
3.To review and refine the triage criteria and/or triage workflow if indicated
Methodology :
The audit was performed in two phases, phase I from 1st Oct 2023 to 31st Oct 2023 and phase II from 1st July 2024 to 31st July 2024. All speech therapy outpatient clinics in NTWC had participated in the audit exercise.
Systematic random sampling of 20% of all outpatient referrals received in the target period was collected from each clinic. Intra-cluster audit was adopted. It was performed by cluster Q&S subcom representative, with reference to a list of 10 identified essential triage workflow procedures.
Result & Outcome :
A total of 68 and 56 samples were collected in phase I and phase II respectively from 4 speech therapy outpatient clinics in 3 hospitals.
The compliance percentage of audit items was high, ranging from 95.59% to 100% in phase I and, from 96.42% to 100% in phase II.
The audit result provides an overview on the latest speech therapy outpatient triage practice in NTWC. High compliance rate in all audit aspects showed a good common triage practice in all speech therapy outpatient clinics. A few missed points scored were mostly procedural careless mistakes caused by hardware incompliance and human error which did not affect the overall triage precision. A standard and proper outpatient new case appointment arrangement across all clinics would be safeguarded. All referral samples were noticed to be timely and appropriately triaged. New case appointment was properly arranged according to clinical urgency. Service gaps and procedural obstacles had been identified with improvement modification immediately implemented.
