Referral to treatment (RTT) pathway and clinicians' awareness – how a small change in practice can make a big difference!
BAUS ePoster online library. Mukherjee S. 11/10/20; 304142; P11-1 Disclosure(s): Nil
Mr. Subhabrata Mukherjee
Mr. Subhabrata Mukherjee
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Referral to treatment (RTT) pathway and clinicians' awareness – how a small change in practice can make a big difference!

Mukherjee S1, Desai R1, Freeman K1, Meganathan V1, Kavia R1
1Northwick Park Hospital, United Kingdom

Introduction:
As per the Referral to Treatment (RTT) pathway a NHS Trust is supposed to start treatment within 18-weeks of receiving a routine, non-urgent referral. Failure of this target not only leads to financial compensation, it also has a negative impact on the trust's performance.

Methods:
We analyzed the cases which either breached or were about to breach 18-weeks target. We then developed a questionnaire containing potentially avoidable ten real clinical situations and requested all the clinicians in urology department to mark the outcome for each situation. Subsequently, the situations were discussed and clinicians were made aware of the appropriate responses. After a gap of one month the clinicians were given the same questionnaire to fill up to ensure that they remember things rightly and are willing to change their practice.

Results:
In the first cycle (17 clinicians) the options 'sending the patient for investigation' and 'add to waiting list' were selected inappropriately in quite a few situations which would keep the pathway open and could potentially lead to 18-weeks breach. In addition, multiple outcomes were selected by some clinicians for a given situation which should not be the case. However, in the second cycle (15 clinicians) all of them selected only one outcome per situation without choosing any inappropriate option. Subsequent review showed reduction in the number of patients breaching 18-weeks target.

Conclusion:
Clinicians should understand the basics of RTT pathway and choose the proper code in clinic to help their trust to minimize 18-weeks breach.
Referral to treatment (RTT) pathway and clinicians' awareness – how a small change in practice can make a big difference!

Mukherjee S1, Desai R1, Freeman K1, Meganathan V1, Kavia R1
1Northwick Park Hospital, United Kingdom

Introduction:
As per the Referral to Treatment (RTT) pathway a NHS Trust is supposed to start treatment within 18-weeks of receiving a routine, non-urgent referral. Failure of this target not only leads to financial compensation, it also has a negative impact on the trust's performance.

Methods:
We analyzed the cases which either breached or were about to breach 18-weeks target. We then developed a questionnaire containing potentially avoidable ten real clinical situations and requested all the clinicians in urology department to mark the outcome for each situation. Subsequently, the situations were discussed and clinicians were made aware of the appropriate responses. After a gap of one month the clinicians were given the same questionnaire to fill up to ensure that they remember things rightly and are willing to change their practice.

Results:
In the first cycle (17 clinicians) the options 'sending the patient for investigation' and 'add to waiting list' were selected inappropriately in quite a few situations which would keep the pathway open and could potentially lead to 18-weeks breach. In addition, multiple outcomes were selected by some clinicians for a given situation which should not be the case. However, in the second cycle (15 clinicians) all of them selected only one outcome per situation without choosing any inappropriate option. Subsequent review showed reduction in the number of patients breaching 18-weeks target.

Conclusion:
Clinicians should understand the basics of RTT pathway and choose the proper code in clinic to help their trust to minimize 18-weeks breach.
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