Improving service delivery by evaluation of the referral pattern and capacity in a clinical genetics setting

AbstractQuality improvement in specialist services such as clinical genetics is challenging largely due to the complexity of the service and the difficulty in obtaining accurate, reproducible, and measurable data. The objectives were to evaluate the pattern of referrals to the All Wales Medical Genetics Service (AWMGS) North Wales Genetics team based in three separate hospitals, define the capacity of the team and implement change to improve equity, timeliness and efficiency of care delivery to patients. The methodology required collating the monthly referral rates retrospectively for each center over a 2.5‐year period and plotting on statistical process control charts. Process mapping of the referral process in each center was undertaken, differences documented and a common pathway implemented. “Did not attend” and “time to first appointment” rates were also measured in one center. PDSA methodology was used to implement “patient focused booking.” The results show that the range for referral rates in any given month for each center was 3–33 referrals. The range for referral rate for the whole team was 18–64 per month. Since January 2004 the average number of monthly referrals to th