Offering vasectomy services in primary care
Dr Mike Holmes - Partner, Haxby Group
Haxby Group Practice has offered vasectomies to patients registered in GP practices in North Yorkshire for the past decade and has now carried out over 3000 procedures in an out of hospital setting. As a result, this has shifted and consolidated the provision of this service locally to primary care.
The aim was to identify areas for development in the productivity and efficiency of the service, applying ‘lean’ thinking to streamline and improve patient flow. This intended to provide the opportunity to embrace technological innovation, maximise utilisation of resources and improve patient experience.
Data was compiled from January 2015 to March 2016, comprising the number of cases performed each session and the time taken to perform each procedure. Patient satisfaction survey results were also analysed. Baseline data preceded an improvement programme, which was developed using quality improvement methodology. The interventions included:
- The implementation of a pre-recorded video explaining the procedure, played during the patient’s pre-operative ‘check-in’ to aid the consent process
- Reduction in the number of days when procedure is performed to create one list, one day per week at one site
- Full use of three adjoining rooms for the procedure
- Increased utilisation of healthcare assistants
The post-intervention data revealed an increase in productivity of up to 40% each month, with an increase of cases per session, reduced DNA rates and a reduction in the number of sessions held. Patient experience increased after the improvement measures.
The implementation of service improvement methodology has not only improved productivity, but the patient experience of the service. We feel that this improvement programme has the potential to be replicated in other day-case community settings.
Nature and impact of intervention
- Patient - Improving access, increasing duration or quality of consultations, seeing same clinician over time, patient education, patient access to records, gaining feedback from patients and using technology and other support tools.
- Practitioner - Training in quality improvement methods, inter-professional learning, audit and feedback, educational outreach visits, improvement collaboratives, decision support tools, nurse-led services and increased staffing levels.
- Practice - Greater amount of research support including: providing wider range of services, quality improvement projects, tele-health, clinical audit, significant event analysis, electronic tools and improving data collection and error reporting, etc.
Practice team roles involved/affected