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Follow on Google News | Torbay Hospital’s PSA Tracker Project Transforms Care for Patients Recovering from Prostate CancerBy: Evoluu The core principle behind the PSA Tracker model is to put patient experience and convenience at the center of the process by redesigning long-term PCa patients’ care to avoid repeated unnecessary hospital visits and still maintain specialist care by means of distant monitoring. As the most prevalent cancer among men, Trusts throughout the UK have seen an increase in the demand for Prostate Cancer (PCa) treatment coupled with limited capacity in Urology departments. Because most PCa patients require a very long follow-up informed by repeated Prostate-Specific Antigen (PSA) blood testing, at least 20% of capacity in urology departments is devoted to routine follow-up appointments - limiting availability and promptness of appointments for other patients. The PSA Tracker model was launched at Torbay in January 2012 and was based on care management processes in use at Bath since 2004. Before it was launched, a check-up for a patient on the PCa care pathway would typically involve considerable time travelling to Torbay Hospital, finding a parking space, and waiting in outpatients, for what often amounted to a very short consultation that was unlikely to result in a change of treatment. Such visits were both inconvenient for patients and inefficient for the hospital. Collaboration between the Torbay and Bath Trusts on PCa care workflows has resulted in a system which dramatically improves a number of aspects surrounding care for patients with prostate cancer whose disease is stable. The benefit for both patients and the Trust has been more streamlined and efficient care as well as improved access to outpatient urology services at the hospital. Mr Magdi Kirollos, the project lead and Consultant Urological Surgeon from South Devon Healthcare NHS Foundation Trust, presented the results of the implementation of the Trust’s PSA tracker system at the International Forum on Quality and Safety in Healthcare conference in April. His research into the impact of the system has shown the Trust is saving money, improving PCa patients’ experience and improving access to new patients in terms of capacity and waiting times. Since launching, over 700 patients who require two or more appointments a year have been migrated to the tracker system – exceeding the target for year one by 16%. Mr Kirollos’s figures show a gross saving for 2011/12 of around £250,000, a large part of which is directly attributable to a saving of 76% on the cost of a follow-up using the tracker (£23) compared to a standard follow-up appointment (£96). He has also demonstrated a minimum drop in the waiting time for new patients from 41 days to 34 days (17%) and the proportion of new patients has increased by 7%. Feedback from a formal Patients and GPs satisfaction survey carried out by the Trust’s audit department in March and April 2013 was also positive. According to 89% of patients, follow up for PCa was delivered on time and 78% of patients rated their confidence in the service as good or very good. GPs have also been receptive to the tracker system with 71% stating that they preferred the new service, a figure supported by the fact that over 95% of GPs said that the Tracker added nothing or very little to their workload. In addition, 89.5% of GPs were satisfied by the information provided back to them. The PSA system is built in InfoFlex, an information platform supplied by CIMS, and replaces the need for routine hospital attendance. The system stores the patients’ individual care plans and administers the schedule of follow-ups. Instead of the patient being summoned to the hospital outpatient clinic, a Clinical Nurse Specialist (CNS) contacts the patient and invites them to attend at their local GP surgery for a blood test. If the results indicate a stable condition, the nurse makes a follow-up call to let the patient know the results, offer self-monitoring advice and inform them that they will be contacted after a specified period (between 3 and 12 months). Any abnormal or unexpected results trigger an individualized appropriate response including an appointment to see a specialist if needed. Chair of the South Devon and Torbay CCG, Dr Derek Greatorex believes the new system will increase capacity by a further 1,500 appointments per year. “People are no longer faced with the hassles of travel or the vagaries of the outpatient system,” he says. “In the past there was no formal recall system and it was all too easy for patients to get lost on the pending list. It also frees up consultants’ For patient Gordon Quick, aged 65, it has meant an enormous difference. He was diagnosed with prostate cancer five years ago and had PSA tests every three months at the hospital. About a year ago a physical examination and biopsy suggested the need for brachytherapy. He is now in a monitoring phase and receives his PSA test at his local GP’s surgery. He is in no doubt about the difference the system has made. ‘It puts it out of sight and out of mind’ he says. In addition to reducing the demand on outpatient clinics and increasing capacity for new and follow-up patients requiring outpatient appointments, the system is also helping the Trust meet its QIPP targets, and minimizes reliance on the Trust’s resources because very little administrative or secretarial support is required to manage these elements of the care pathway. After presenting the PSA Tracker at the International Forum on Quality and Safety in Healthcare and its inclusion in NHS innovation catalogue, the project team hopes to have the system recognized as an example of best practice for the NHS and that similar systems will be rolled-out at other Trusts throughout the NHS. FOR MORE INFORMATION: Phillip Brown Sales and Marketing Director T: 01923 896939 PBrown@infoflex- www.infoflex- End
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