Reducing Wait Times for Patients under Consideration for Tonsillectomy

The aim of this quality improvement project is to reduce wait times for patients under consideration for tonsillectomy. In 2017, in the Republic of Ireland, 5,267 patients presented to Otolaryngology, Head and Neck surgery services with acute and chronic tonsillitis. In the same year, 3,690 patients underwent tonsillectomy making this procedure the second most commonly performed in this surgical specialty in the country. The project focuses on the wait time between General Practitioner referral and the Ear, Nose, and Throat outpatient department clinic. In order to establish a baseline in the hospital where this project is being carried out, the number of patients attending the Ear, Nose, and Throat outpatient department clinic for routine tonsillectomy was gathered over a five week period. Based on this data, it is estimated that 348 patients attend the clinic yearly for routine tonsillectomy referrals. Current average wait time to attend the outpatient department clinic after routine referral is 17 months. This quality improvement project proposes implementing a virtual clinic via telephone, in lieu of the patient attending an in-person consultation. The goal after introducing the virtual clinic is to reduce wait time for this patient group by 20% over six months and by 50% long-term. This would result in a decrease in wait time by 3.5 months and 8.5 months respectively. The DMAIC model was the chosen approach for this project. A stakeholder analysis, patient process flow map, run chart, and fishbone diagram were quality improvement tools used in conjunction with this model.