PKB supports trusts' elective recovery plans for Outpatient Optimisation with our understanding and experience with patient remote follow-up, reducing the amount of outpatient appointments needed knowing patients can have their care delivered at home through PKB.

PKB supports trusts to optimise outpatient clinics in many ways, such as optimising outpatient clinics, reducing the number of outpatient appointments, reducing missed appointments, supporting the implementation of a digital pre-assessment pathway and reducing phone calls using PKB key features.

Current Problems

• Large waiting times

• High missed appointment rates

• No digital pre-assessment pathway

• Patients attending unnecessary appointments

• Appointments are lengthy and expensive

• Patients have no control

• Long waiting times for appointments

PKB solutions

Tools in every PKB deployment to support outpatient delivery

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Use case

Reducing Missed Appointments

Patients who did not register for PKB had DNA rates of 6.23%, while those who did register DNA only 4.05% of their appointments - a 35% reduction. This is the data from millions of appointments over 12 months across 19 providers who store their appointment data in PKB. 

By sending appointment letters digitally with a read receipt and adding appointment data to a patient's PKB record, organisations can give patients more chances to be aware of the appointment.

Triage/preassessment programmes

Hull University Teaching Hospitals implemented a digital pre-assessment pathway,  sending questionnaires to patients via PKB to determine what level and type of interaction a patient needed before surgery. The answers are extracted and inputted to a local custom-built dashboard used by the Admin and Nursing team to triage patients. In just the pilot period:

• Since starting the PKB pathway, no PKB patient has had an on-the-day cancellation

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Reducing admin/appointments

Swansea Bay Dermatology Team prompts a patient within PKB when they need to book their blood tests. Once the test results are returned to the clinician, they conduct this review independently and inform the patient via PKB when their prescription is ready to collect and changes they may have made. They’ve had a 75% reduction in face-to-face outpatient appointments (reduced from 4 quarterly to 1 annual appointment). ‘Follow-up not booked’ list of patients eliminated (*reported pre-COVID19).

HUTH Rheumatology Healthcare Prescription Team uses PKB’s questionnaire feature to remind patients to book their blood test to reduce the amount of time the team currently spends printing and sending letters to each patient, as well as the follow-up phone calls to produce prescriptions and the cost of sending letters in the post. Approximately 46 hours per year (1.5 weeks) of admin time is saved and can be redeployed for other uses. The team aims to increase this to 2 full weeks of saved admin time.

Reducing calls

East Sussex - Uro-oncology Team

Using questionnaires to review patients every six months. The results go through to an admin who will triage the results. This used to be managed with a telephone appointment with every patient, asking questions and discussing concerns. This has caused a reduction of over 50% of telephone calls.

Swansea The Rheumatology team

Use PKB to allow patients to check their blood test results, which are automatically shared via the portal. Patients on disease-modifying drugs can securely use the portal to message the rheumatology team if they have queries. This has led to a 75% reduction in calls to the service’s advice line from patients with queries regarding their appointments or blood results.

Key features

There are key PKB features all services can use. A list of them is below.

Questionnaires 

Teams can use PKB’s FHIR trigger API to automate sending questionnaires to service users, and they can use PKB’s FHIR API to extract completed responses back into their Organisation's electronic patient record (EPR) for review.

Patients can initiate a questionnaire by clicking start questionnaire on their homepage or directly within the NHS App. Once completed the questionnaire can be sent to a professional or team.

PKB's advanced questionnaire functionality

The features include:

• Scoring and calculations

• Branching, allowing patients to complete the parts of the questionnaire that are relevant to them

• Coded fields questionnaires can be mapped to clinical codes

• Patients can save drafts

• Send questionnaires to patients who aren’t registered or already in your team

Questionnaire templates

• Pre Op Questionnaire (preparing patients for their appointment)

• Prehab - Healthy Eating Questionnaire

• Quality of life questionnaires

• Pain questionnaire

• Enhance recovery after surgery questionnaire

• Capturing Digital Outcome Measures

Messaging 

• Patients have access to message their healthcare team (saving time on the phone)

• The Admin team can triage messages. Either resolving or passing onto another speciality team

• Universal Messaging is the ability for patients to message clinical and non-clinical teams

• Team-based messaging allows teams to automatically receive secure messages and questionnaires as a group rather than as individuals

Library 

• Waiting well information and support 

• Online patient leaflets

• Support group information

• Videos

• Generic appointment information 

Care plans 

PKB care plans can be used at every stage of a patient's condition journey, below are some of the care plan templates being used and templates that can be created.

• Living Well for Longer

• Condition information and resource care plans

• Monitoring condition plan (example cardiology monitoring care plan)

• Rehab, physical activity and musculoskeletal health

• Goals setting care plan

• Peri-operative care plans

Appointments 

• Appointment letters and appointments sent to PKB via integration

• Manually entered appointments

SMART goals

Reduce the number of appointments for the ………. team by Sept 2024 (12 months post team go live) from (current appointments) to ( %) by adding all patients to a PIFU pathway (if they fit the criteria), schedule questionnaires to be sent ….. Current appointment rates are (%). 12 months post go live, the team compared appointment rates of patients with and without a PKB record. It is a local NHS priority to add patients to a digital PIFU pathway to reduce waiting lists and to save money.

Reduce the number of missed appointments (DNA) for the rheumatology team by Sept 2023 (12 months post team go live) from (current missed appointments) to ( %) by sending all appointment letters and appointment details into PKB instead of by post. Current missed appointment rates are (%). 12 months post go live, the team compared missed appointment rates of patients with and without a PKB record. It is a local NHS priority to reduce missed appointments to save money.