PKB can support trusts in many ways to optimise outpatient clincals, to reducing the amount of outpatient appointments, reduce missed appointments, support the implementation of a digital pre-assessment pathway and reducing phone call, by using PKB key features.
Current Problems
Large waiting times
High missed appointment rates
No digital pre-assessment pathway
Patients attending an 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
Use case
Reducing Missed Appointments
Patients who did not register for PKB DNA 6.23% of their appointments, while those who did register DNA only 4.05% of their appointments - a 35% reduction. This is the data from nearly millions of appointments over 12 months across 19 providers who store their appointments data in PKB.
By sending appointment letters digitally with a read receipt and adding appointment data to a patients PKB record, organisations can give patients more chance of being 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 ahead of 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:
96 hours of face to face appointments were avoided
An additional 94 hours of face to face switched to phone calls
127 f2f appointments were a reduced length
Since starting the PKB pathway no PKB patient has had an on the day cancellation
by the trust due to health reasons.
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. 75% reduction in face-to-face outpatient appointments (reduced from 4 quarterly to 1 annual appointments). ‘Follow-up not booked’ list of patients eliminated (*reported pre-COVID19)
HUTH Rheumatology Healthcare Prescription Team uses PKB’s questionnaire feature is used 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 currently saved and able to be redeployed for other uses. The team is aiming to increase this to 2 full weeks of admin time saved.
Reducing calls
East Sussex - Uro-oncology Team
Using questionnaires to review patients every 6 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 the questions and talking through 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 being
shared via the portal. Patients who are on disease-modifying drugs can use the portal to
message the rheumatology team securely 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 validating waiting list 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.
New Advanced Questionnaires
By the end of 2023, organisations will be able to use PKB’s new 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 that 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
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 consultations 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
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.