Adult Weight Management Service

Understanding the Problem

The assessment process for the Adult Weight Management Service (AWMS) does not meet the needs of the patients in a timely and efficient manner, indicated by the high number of appointments before patients were referred to services other than dietetics. With the overall AWMS increasing its multidisciplinary service offers, this problem is likely to get worse and impact every patient referred to the AWMS.

Measures: How will we know a change is an improvement?

The Theory of Constraints was demonstrated using the Cause and Effect (fishbone) diagram, data and process map with the project team and wider stakeholders to understand the problem and identify the potential change ideas represented in the driver diagram below:

Changes: What changes can we make that will result in and improvement?

100% of patients have had their primary needs identified at their 1st appointment since the introduction of the biopsychosocial assessment but the more efficient way of triaging and identifying needs has led to an increase in demand and waiting times. A recovery plan was enacted to tackle this utilising QI methodology and the PDSA approach.

This project will address key components of the 6 domains of Quality in Healthcare: Patient Centred, Efficient, Equitable, Timely

Involving others

The main stakeholders were the clinicians working within the WM team, administrators, patients and those referring into the WMS. The project team reported back to the wider WM team and sought their feedback and opinions on the proposed changes. The administrators were included as part of the project team as their role was key to the successful implementation of the project. Feedback was provided to referrers via primary care cluster meetings. Patients views on the changes to the assessment process will be sought as part of the project evaluation.

The project teams consisted of the Weight Management Clinical Pathway Lead, Lead Clinical Psychologist for WM, Lead Dietitian, WM Administrator, 3 Dietetic Assistant Practitioners and an Assistant Psychologist, supported by a Quality Improvement Practitioner.

The improvement was a co-design among professions with the intention of engaging service users, to inform the development of the service.

Aim: What are we trying to accomplish?

To reduce the number of appointments needed to correctly identify individual patient needs within the AWMS to 1 appointment within 6 months.

Reflection and the next steps