Duvnjak Haris, Ammori Mohannad B
Otolaryngology, Wrexham Maelor Hospital, Wrexham, GBR.
Trauma and Orthopedics, Wythenshawe Hospital, Manchester, GBR.
Cureus. 2022 Nov 30;14(11):e32063. doi: 10.7759/cureus.32063. eCollection 2022 Nov.
Background Osteoarthritis is a substantive burden on the population and National Health Service (NHS) in the United Kingdom. A recent systematic review suggests that intra-articular steroid injections are an efficacious conservative treatment modality. The NHS Constitution states that "patients should wait no longer than 18 weeks from GP referral to treatment." An NHS hospital trust failed to meet this standard in a quarter of patients waiting for an intra-articular steroid injection of the hip. Strategies were considered to improve the time from referral to treatment (RTT). The aim of this quality improvement project was to improve the efficiency and capacity of the injection list. Materials and methods Patients who underwent an injection on a list between January and April 2019 were identified. Data were retrospectively collected and included the sites of injection and waiting times. Proformas for documentation and discharge summaries were introduced. Time taken for each appointment pre- and post-intervention were compared with the aim to increase the number of patients per list. Results Thirty-six (26%) of 138 patients experienced delays beyond 18 weeks from RTT. The mean (standard deviation [SD]) number of weeks waiting for an injection from the time of referral was 14 (6). The mean (SD) time for each appointment was 12 minutes 36 seconds (7 minutes 36 seconds) pre-intervention and 8 minutes 36 seconds (3 minutes 12 seconds) post-intervention. Discussion and conclusion Our standardized proformas led to an improvement in efficiency by reducing the time taken for documentation and capacity by subsequently increasing the number of patients per list.
骨关节炎给英国的民众和国民医疗服务体系（NHS）带来了沉重负担。最近一项系统评价表明，关节内注射类固醇是一种有效的保守治疗方式。NHS章程规定，“患者从全科医生转诊到接受治疗的等待时间不应超过18周”。一家NHS医院信托机构在四分之一等待髋关节关节内注射类固醇的患者中未能达到这一标准。人们考虑了一些策略来缩短从转诊到治疗（RTT）的时间。这个质量改进项目的目的是提高注射名单的效率和容量。材料与方法：确定了2019年1月至4月期间在名单上接受注射的患者。回顾性收集数据，包括注射部位和等待时间。引入了记录用的表格和出院小结。将干预前后每次预约的时间进行比较，目标是增加每份名单上的患者数量。结果：138名患者中有36名（26%）从RTT开始经历了超过18周的延迟。从转诊时起等待注射的平均（标准差[SD]）周数为14（6）周。干预前每次预约的平均（SD）时间为12分36秒（7分36秒），干预后为8分36秒（3分12秒）。讨论与结论：我们的标准化表格通过减少记录时间提高了效率，并通过随后增加每份名单上的患者数量提高了容量。
