• Despite compliance with mandatory training, staff lacked confidence in their delivery. 100% of staff surveyed had received information from one or more of the methods utilised. (Figure

C.J. Ung and A. Rai Dental Core Training King’s College Dental Hospital

BACKGROUND

The COVID-19 pandemic has resulted in profound changes in dental service provision in both primary and secondary care settings. King’s College Dental Hospital has served as a prominent urgent dental care hub in London, and has lead to an increased volume of patients seeking access to emergency dental services.

The huge demand has resulted in the need for triaging of incoming calls, enabling identification of patients who are clinically appropriate for treatment, who are then assessed and treated on the Acute Dental Care (ADC) Department. Patient details are collated daily from the dental emergency telephone line to be triaged by clinicians. Triaging can be a stressful experience for staff and many see this as the least enjoyable part of their day.

AIMS

• To improve staff satisfaction and reduce staff anxiety and stress during the dental triage process. • To ensure patients are appropriately triaged to be seen on ADC.

First Cycle Results

The majority of clinicians reported that telephone triaging is a stressful experience due to limitations in the triaging system, specifically a lack of acceptance criteria. An updated triage pro-forma which includes clear acceptance criteria was created to facilitate information gathering. Improvements and relevant advice addressing reported concerns were disseminated during a departmental staff meeting. Clinician experience was re-measured to evaluate the impact of said improvements on staff experience. There is a need to telephone triage patients to assess suitability for treatment. Improvements can be made to the telephone triage system which can potentially reduce stress levels in staff members. Clinicians responded positively to the new form and the inclusion of access to a generic email have made the process easier.

METHOD

Survey designed to measure clinician experience and obtain written feedback. Pilot survey distributed – confirmed need for improvement and led to improvements in survey design

The quality improvement method utilised the plan, do, study, act model for improvement

RESULTS

PROBLEMS IDENTIFIED/ SUGGESTIONS

CHANGES IMPLEMENTED

Lack of prompts on form/ postcode issues NEW TRIAGE FORM

Unclear criteria NEW GUIDANCE & CLARIFICATION

Lack of facial contact

High stress experienced by staff

ACCESS TO GENERIC EMAIL FOR PATIENTS TO EMAIL PICTURES

AWARENESS OF STAFF WELLBEING SERVICES

Language barriers GUIDANCE FOR USING LANGUAGE LINE

Fig. 1 Feedback from clinicians and the relevant changes made to the system. Fig. 2 The new pro-forma for information gathering.

Second Cycle Results

Clinicians reported positive responses to the changes implemented, in particular the availability of prompts on the triage sheet and access to a generic departmental email address for liaising with patients, which has helped to improve patient communication and streamline the triage process.

CONCLUSION

First Cycle

Second Cycle

Fig. 3 Responses show a small reduction in those reporting triaging as a stressful experience (6 and over) after the implementation of changes Whilst the reduction in clinicians reporting triaging as a stressful experience is reassuring, the results are indicative that further measures could be taken to address outstanding concerns and demonstrates scope for further improvement.

REFERENCES

1. n.d. Plan, Do, Study, Act (PDSA) cycles and the model for improvement. [ebook] NHS England and NHS Improvement.

Available at: <https://www.england.nhs.uk/wpcontent/uploads/2021/03/qsir-plan-do-study-act.pdf> [Accessed 16 May 2021]. 2. Dawson, J., 2014. STAFF EXPERIENCE AND PATIENT

OUTCOMES: WHAT DO WE KNOW?. [ebook] NHS Employers.

Available at: <https://www.nhsemployers.org//media/Employers/Publications/Research-report-Staffexperience-and-patient-outcomes.pdf> [Accessed 16 May 2021].