Endoscopy pathway Great Ormond Street Hospital

The project came about due to a relatively high level of complaints and Patient Advice and Liaison Service (PALs) issues where the existing pathway for patients requiring an endoscopy had not been joined up effectively nor viewed from the patient perspective.

Communications problems were the main area of concern. These were being experienced throughout the patient journey – at admission, on the ward/in theatre, post op follow-up and at discharge.

The overall aims were to:

• exceed patient, family and referrers’ expectations by streamlining and re-designing the pathway using patient-centric processes and information
• make the journey less stressful for patients, their families and for the staff involved.

Specific goals included to:

• measure and monitor the experience of patients
• improve communications – with the patient, between teams/individuals internally and with referrers and community teams
• reduce waiting times at all stages
• involve patients in decisions
• clarify protocols and referral criteria
• ensure appropriate co-ordination and preparation for each stage
• ensure the outcome(s) of the admission and any requirements for follow-up care were arranged within a clinically appropriate timeframe and communicated clearly.

These were achieved by:

• understanding the existing patient and family experience using experience based co-design, patient shadowing, questionnaires and a focus group
• understanding the existing staff experience using process mapping including role lane mapping and information pathway mapping
• using improvement methodologies to test/implement new ideas
• reporting against project measures
• evaluating, embedding and rolling out new practice to other services.

Who was involved?

As well as involvement from across the range of clinical and non-clinical staff, support and expertise was provided by the trust’s Transformation Information analyst team for measurement metrics and project evaluation. The project was monitored by the Trust Patient and Public Involvement & Experience Committee (PPIEC) which includes patient and family representation.