Authors :
Prathapasinghe ID; Carone Vito; Win Kaung H. H.; Venoden D.; Bartholameusz Tilan; Haynes Andrew; Fernando Devaka J. S.
Volume/Issue :
Volume 11 - 2026, Issue 4 - April
Google Scholar :
https://tinyurl.com/pm294t62
Scribd :
https://tinyurl.com/3cra87ry
DOI :
https://doi.org/10.38124/ijisrt/26apr1029
Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.
Abstract :
Timely decision-making in outpatient endocrinology clinics is essential for optimizing patient care and resource
use. This quality improvement (QI) project aimed to reduce the time taken to reach clinical decisions by introducing a
signposting system to facilitate pre-clinic investigations. The intervention was developed and implemented collaboratively
across organisational boundaries, using evidence-based improvement methods and shared leadership principles. A
multidisciplinary team—including clinicians, administrative staff, and laboratory services—mapped current workflows,
identified delays, and co-designed a streamlined signposting process to ensure necessary investigations were completed
before appointments. Implementation involved iterative Plan-Do-Study-Act (PDSA) cycles, staff training, and continuous
feedback. Post-intervention data demonstrated a measurable reduction in decision-making time within clinics, improved
patient flow, and enhanced staff satisfaction. The project highlights how shared leadership and effective teamwork can drive
sustainable improvements in care delivery across complex healthcare systems, ensuring that evidence-based interventions
translate into meaningful operational and clinical outcomes.
Keywords :
Referral to Treatment; Hypercalcaemia; Endocrinology; Pareto Analysis; Plan do Study Act (PDSA).
References :
- NHS England. Referral to treatment. https://www.england.nhs.uk/rtt/ [accessed 15 May 2019]
- Minisola S, Pepe J, Piemonte S, Cipriani C.. The diagnosis and management of hypercalcaemia. BMJ 2015; 350(h2723): https://www.bmj.com/content/350/bmj.h2723 [accessed 14th May 2019].
- Srinivas V, Gomez J,Kerry S, Swords FM. Preclinic investigations accelerate decision-making, reduce delays in treatment and are highly popular with endocrinology patients and staff. Clin Endocrinol 2014; 81(6): 929 -935. https://www.ncbi.nlm.nih.gov/pubmed/24750174 [accessed 15 May 2019]
- Lenkalapally A, Aarella V, Fernando DJS. Improvement of Right to treatment pathway in management of Primary Hyperparathyroidism', Clinical Audit SFH.
- Prathapasinghe ID, Venoden D, Somaratne CJK, Win KHH, Abhishek VYAS, Akthar I, Fernando DJS. Analysis of RTT Hyperparathyroidism pathway. Clinical Audit SFH.
Timely decision-making in outpatient endocrinology clinics is essential for optimizing patient care and resource
use. This quality improvement (QI) project aimed to reduce the time taken to reach clinical decisions by introducing a
signposting system to facilitate pre-clinic investigations. The intervention was developed and implemented collaboratively
across organisational boundaries, using evidence-based improvement methods and shared leadership principles. A
multidisciplinary team—including clinicians, administrative staff, and laboratory services—mapped current workflows,
identified delays, and co-designed a streamlined signposting process to ensure necessary investigations were completed
before appointments. Implementation involved iterative Plan-Do-Study-Act (PDSA) cycles, staff training, and continuous
feedback. Post-intervention data demonstrated a measurable reduction in decision-making time within clinics, improved
patient flow, and enhanced staff satisfaction. The project highlights how shared leadership and effective teamwork can drive
sustainable improvements in care delivery across complex healthcare systems, ensuring that evidence-based interventions
translate into meaningful operational and clinical outcomes.
Keywords :
Referral to Treatment; Hypercalcaemia; Endocrinology; Pareto Analysis; Plan do Study Act (PDSA).
