Abstract
Introduction Increased referrals for sleep diagnostics have led to long waiting times at many sleep centres. One of the metrics for measuring this has been diagnostic waiting times and activity (DM01). We have struggled to meet this for many years and our current equipment was leading to high failure rates and repeated tests (25%). We undertook a quality improvement project to determine if remote testing would lead to reduced turnaround time and failure rate.
Method Patients referred into our service from start of May 2023 were referred to Sleep Health Solutions Ltd (SHS) PSS who called the patients and arranged a telephone appointment to complete a (SHS) computer guided consultation (GC). The PSS then arranged for a WatchPAT One or 300, (Itamar Medical) to be couriered to the patient depending on smart device availability. The WatchPAT One report was uploaded to the cloud and then directly placed in the SleepHealth patient notes, also cloud based and DPIA protected allowing the hospital team to see the report immediately.
Results Preliminary results show that 387 patients were referred during May with 118 patients sent a WatchPAT device so far; 117/118 were WatchPAT Ones, failure rate 1%. The time from GC review to the study reported and uploaded into patient notes was 7.6 days. Previous data showed turnaround times of 42 days for unreported studies (variety of multichannel devices); NICE guidelines for high risk patients was not being met nor was referral to treatment time.
Discussion Preliminary data has shown that there is a significant reduction in failure rates and turnaround time with this project. Our previous work has shown that, with the improved patient information (GC) combined with robust diagnostics, a treatment decision can be made in 85% of patients. The additional pathway changes reported here allows performance targets to become achievable.