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Welcome to new blog about CTS

Posted Sep 16 2007 12:00am


A study made in Leicester in February 2007 . I'll write more about this when I've a chat with Veijo Lesonen. Details to be found in powerpoint presentation. Download ppt .

Delivering the 18 week Patient Pathway
  • 17th July 2007 by Malcolm Clarke
  • Can it be done?
  • By whom?
  • When?
  • How?
The Leicester Experience
  • Overview Leicester Carpal Tunnel Service
  • Traditional ways of working
  • The Leicester Experience
  • Traditional NCS in U.K.
  • New Method of NCS
  • Anglo-Finnish Collaboration
  • Results /Audit
  • Nurse Operating

Overview Leicester C.T.Service
  • Nurse Led service
  • 850 Operations per year
  • 1100 New patients
  • 1200 Follow-ups
  • Average back to work post op 4 Days
  • 12wks from referral to discharge

Traditional Ways of working
  • Totally Ineffective
  • Costly (wasteful Tax payers Money)
  • Overkill on Resource (Theatre, Day Bed)
  • Overuse of Manpower (Doctors, Nurses,Admin)
  • Not Patient Friendly (Intimidating not Natural)
  • Time Consuming ( Too Many Handoffs)

The Leicester Experience
  • Highly Effective
  • Value for Money (No Bed, No Theatre)
  • Minimum Resource (Treatment Room )
  • Small Manpower Resource (3People)start to finish
  • Extremely Patient Friendly (Non Threatening)
  • Time Effective ( Fast, Efficient Patient Pathway)

Savings to be Made being Effective
  • No Bed £250 per half day
  • Theatre £400 per half hour
  • N.C.S £160 per Test

Traditional N.C.S. U.K.
  • 16-20 Week Wait and can be much longer
  • Cost between £120-£400 per test
  • Referral to different hospital
  • Not nice test for patient
  • Long Referral to Discharge
  • Totally Unacceptable

Anglo-Finnish Collaboration
  • Leicester-Oulu
  • 65 Patients
  • All Traditional and Mediracer Tests
  • 61 Operations for CTD
  • 6mth Follow-up Mediracer (Sept 2006)
Results submitted for Publication
  • Results/Audit Nurse Operating
  • 3500 Operations
  • 6000 New Referrals
  • 8000 Follow-ups
  • 97.8% Success Rate
  • 2% Complication Rate
  • High Patient and GP satisfaction rate
New Method of NCS
  • No Wait (Test at 1st Appointment)
  • Costs about £25-£30 for disposables
  • No Referral to other Hospital required
  • Comfortable for patient
  • Results at 1st Appointment
  • Treatment Discussed

Outcome
  • Completion of Whole Treatment inside the 18 week timeframe.
  • Guaranteed For all Patients
  • Happy Patients/Relatives/Clinicians
  • Shorter Waiting Lists
  • Quality deliverance of care
  • Hospitals able to tick the box
  • Government achieve projected goals and claims
Early return to work\u000B
  • £76.40 per day CBI Figures
  • Sick pay, Lost Productivity,Loss of Tax
  • 100 patients/ 75 working age
  • 6 weeks off work/ 2 weeks off work
  • £240,660 / £80,220
  • 42,000 Ctd per year = Savings
  • £67,384,800.00 one condition
  • Smarter Thinking + Early return to work
  • = Savings of £91,114,800.00 Minimum for the condition of Carpal Tunnels alone

The Future
  • Patients treated in a one-stop Pathway
  • No limit on patients treated
  • No making patients wait 18 weeks
  • Money saved invested back into services
  • Safe guarding the NHS

Summary
  • Clinically Led -Patient focussed services
  • Nurse Led/Others from referral to discharge
  • Large input on patient Comfort/Satisfaction
  • Do use Cost Effective methods for Tests and Surgery
  • Do not use theatres ( Usually £800 per hour)
  • Do not use beds ( Usually £250 per half Day)
  • Early Return to Work+Change of Practice could save a minimum of £100 Million
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