Improving The Attendance, Selection Criteria and Patient Flow Through An ENT Virtual Clinic

The global COVID-19 pandemic has increased the waiting times for medical and surgical outpatient appointments and was the impetus for an increase in virtual clinics and telemedicine in Ireland and other countries. The World Health Organisation declared a global pandemic in early 2020 and the implementation of the ENT virtual clinics in the project hospital occurred in May in Ireland. Data collection from this study revealed that between June and December 2020, a total of 590 patients completed appointments through the ENT virtual clinic. Of the 590 patients,65% (n= 384) required an in-person appointment after completion of the virtual clinic appointment. Secondly, there was a 24% (n= 142) failure to attend rate within the virtual clinic. The data suggested that hearing loss, previous mastoidectomy surgery and recurrent tonsilitis are the most common presenting complaints seen in the ENT virtual clinic. Further examination of the data highlighted hearing loss, previous mastoidectomy surgery and recurrent ear infections as the most common complaints requiring an in-person appointment subsequent to their virtual appointment. Of the ENT subspecialities, Otology was recorded with the highest quantity of patients requiring an in-person appointment, with Laryngology second and Rhinology as the least number requiring an in-person appointment. The focus of this project is to improve the attendance, the selection criteria and the patient flow through the ENT virtual clinic. The use of the Lean Six Sigma Model with the DMAIC framework and additional quality improvement tools assisted with the development of this project and the proposed plan.