E021 Patient initiated follow-up long term condition pathway audit

Abstract

Abstract Background/Aims In October 2022 we created a PIFU Long Term Condition (PIFU-LTC) pathway for our department in line with guidance issued by GIRFT for rheumatological patient initiated follow-up. Entry and exclusion criteria for the pathway were agreed by clinicians. Entry criteria included presence of a relevant diagnosis and established disease (≥ 12-month duration). Exclusion criteria included significant cognitive impairment and/or communication difficulties. Guidance regarding documentation standards, follow- intervals and responses to patient contacts were formalised in the standard operating procedure. We undertook an audit of the pathway to evaluate successes and identify areas for improvement. Methods Between 3/10/22 and 30/3/2023 520 patients had been added to the pathway. A random sample of 10% (n = 52) were audited. Data was extracted onto a bespoke data collection proforma. Data collected included: entry and exclusion criteria for the pathway, current medications, subsequent flares and time to review. Results 33 female and 19 male patients were audited. 86% (n = 45) were of White ethnicity. Mean age was 61 (range 20-83). 81% (n = 42) of patient diagnoses met entry criteria for the pathway. Other diagnoses included osteoarthritis, gout and undifferentiated arthralgia. 92% (n = 48) joined ≥12 months since initial diagnosis. 1 patient had significant cognitive difficulties. Documentation regarding information provision was poor. 40% (n = 21) of patients had no record of being provided a PIFU-LTC information leaflet. 33% (n = 17) had no documentation regarding action to take in case of a flare. 15% (n = 8) of patients had contacted the department since entering the pathway (range 21 to 288 days after joining). 6 of these patients reported a disease flare. Duration between patient contact and telephone review by a clinician ranged between 1- 3 days. 4 patients were also offered a face-to-face clinic appointment, with a range of 2-22 days from first contact until this review. As of October 2023, only 3 patients had been taken off the PIFU pathway. Conclusion This audit had highlighted successes, included the numbers of patients moved onto the pathway and limited inclusion of patients meeting exclusion criteria. Key areas for improvement include improving documentation standards in clinic letters, ensuring adequate information provision to patients and reducing delays to face-face clinic follow up. Further development of the pathway may include expansion of the pathway to other diagnostic groups. Disclosure J. Ellis: None. C. King: None. A. Loganathan: None. R. Sengupta: None.