Electronic Booking System Research Articles

Tackling efficiency in a high demand orthopaedic clinic.

Surgical outpatient clinics continuously face challenges in delivering efficient and effective care. An expanding population and chronic staff shortages makes sustainability critical. The primary objective of this study was to identify modifiable factors contributing to longer wait times in an orthopaedic outpatient clinic. A single-centre prospective observational cohort study was conducted at Western Australia's state trauma centre. Over a four-week period, clinicians completed forms identifying delays in clinic, and clinic numbers were captured through an electronic booking system. Data was analysed using SPSS v27. Face-to-face (FTF) and telehealth (TH) clinic volumes grew by 18.9% and 361.1% respectively between 2018 and 2022. For the study period, 754 forms were completed for attending clinic patients. This captured 42.4% and 96.8% of FTF and TH actual attendance. The average wait time for doctor consultation was 63.9 min. Wait times significantly reduced when x-rays were performed prior to clinic (P < 0.001), and when an unaccredited registrar held the on-call phone (P < 0.001). Trauma clinics ran overtime in 95% of cases compared to elective clinics in which 25% ran overtime. The golden staffing ratio was one doctor for 13 patients. TH experienced few delays related to technological fault. This study demonstrates that clinic volume continues to rise. It highlights the demand for adequate staffing and identifies several modifiable factors that influence clinic efficiency. It demonstrates the growth of TH as an alternative modality for outpatient surgical services and its potential for future expansion.

Developing and designing the e-Bosy reservation system for ICT equipment

E-bosy booking system was designed as a reservation system for information and communications technology (ICT) equipment in Universiti Malaysia Kelantan (UMK), Malaysia. Currently, all the reservation systems are done manually, through filling out the form or through email. Using this existing system faces numerous challenges, such as the absence of knowledge of available spaces, tediousness improper management of reservations, clashes in reservations, communication failures, and missing the submitted reservation form. Thus, the development and design of the e-Bosy system (electronic booking system) were intended to bring the efficiency and friendly user of reservation systems both at home and aboard. The system basic functions are designed according to the general requirement including user’s registration and login, online equipment booking, personal center, centrege board and database construction. Through e-BoSy the system, every reservation has been recorded for the future improvement of the services.

PQIP: increasing recruitment through improved patient screening processes

Background: Maximising recruitment was one of the Perioperative Quality Improvement Programme (PQIP) ‘top 5 priorities’ in 2021/22.1 At South Tees, we found that not all patients undergoing lower gastrointestinal operations at South Tees were being screened effectively. The aim of this project was to evaluate whether a new system introduced to improve screening and recruitment rates had been effective, before rolling out PQIP to additional specialties. Methods: Initially, a list of all colorectal operations conducted each month was obtained from the theatre administrator. This was then cross matched with the PQIP procedures list to identify all patients who would have been eligible. A new system was introduced in January 2022 which allowed the research team to access theatre lists and patient details via an electronic booking system. Results: Patient data were collected for colorectal patients for 19 months—from June 2021 to December 2022 and for urology patients from April to December 2022. Identification rates were highly variable until February 2022, after which it remained above 90% for all but 1 month. Although the percentage of eligible patients recruited remained variable, there was a clear upward trend over the study period. The upward trend in recruitment was also subsequently maintained after inclusion of a second surgical specialty. Figure 7 shows the percentage of eligible patients identified for screening. Conclusion: The new screening approach taken at South Tees has improved the percentage of eligible patients identified and subsequently recruited to PQIP. We have also demonstrated that the high screening rates can be maintained when widening participation to further specialities. The authors thank the research team at James Cook Hospital for their support in collection of the data for this project. 1.Edwards, K-E, Singleton G, Vindrola-Padros C, et al. 2021. Report 3: August 2019-July 2021. Perioperative Quality Improvement Programme. NIAA Health Services Research Centre, London.

CEPOD—collaborative effort for patient outcome development

Background: Operating theatres available 24 h a day for emergency surgery (CEPOD theatres) were introduced in the early 1990s after recommendations of a Confidential Enquiries into Perioperative Deaths (CEPOD).1 However, their efficiency remains a challenge. Multiple interdependent factors interact for a patient to be operated on in a timely and safe way. This project attempted to identify inefficiencies in the process of getting an emergency patient to theatre and introduced improvements to the system to optimise use of theatre time. Methods: Over a 1-month period, we collected data on 95 patients who were operated on in the CEPOD theatre. Data collection was done between 0800 and 1800 every day, including weekends. The information collected included time of booking, time of surgery, CEPOD category, and length and reason for delay if applicable. The steps in preparation that were considered were preparation by the surgeon, anaesthetist and the ward, team briefing, sending and arrival to the CEPOD theatre. Results: There were missing data for three patients, with data for the remaining 92 analysed. In most of the cases (61%), a delay in one or more steps in the preparation was identified. Half of the bookings belonged to the urgent category (total 46) that required surgery within 2–6 h, but in 56% of these the target was not met. The median waiting time for immediate surgery was 1 h, for urgent surgery was 7 h and 7 min, and for an expedited surgery was 15 h. When analysing the cases with delays individually, there was a clear pattern in which one delay led to delays in the subsequent steps. Conclusion: There are many steps that could be taken to streamline the patient flow and reduce delays, with the potential to improve patient outcomes. We presented the data at clinical governance meetings of all surgical subspecialties and collated feedback on improving efficiency and engagement. The action plan included an 8 am CEPOD theatre ‘huddle’ where surgical specialties discuss their listed patients and agree a list order, a transparent and remotely accessible electronic booking system, a ‘golden’ patient prepared the previous day to be first on the list, a checklist to ensure each patient is adequately prepared, appointment of leads from surgical and anaesthetic teams to drive progress, and better engagement through taking collaborative decisions. A re-audit is in progress. 1.Buck N, Devlin HB, Lunn JN. The report of a confidential enquiry into perioperative deaths. London: Nuffield Provincial Hospitals Trust/King's Fund Publishing Office 1987. Available from https://www.nuffieldtrust.org.uk/files/2017-01/confidential-enquiry-into-perioperative-death-web-final.pdf (accessed 20/03/23)

1172 APPLYING THE NATIONAL STANDARDS OF PERIOPERATIVE CARE OF OLDER PEOPLE UNDERGOING EMERGENCY LAPAROTOMY (NELA)

Abstract Introduction There are well documented in-equalities for outcomes for surgical intervention associated with Age and Frailty including emergency laparotomy. NELA data has shown over half of such patients are over 65 years old about one fifth are over 80. These patients having significantly higher mortality, longer hospital stays and it has also shown frailty to be an independent marker of poor outcomes. Through application of key standards these outcomes have improved however input from “consultant geriatrician-led MDT” remains stubbornly low nationally. Aims To improve local Trust performance in meeting the NELA standard: “Peri-operative assessment by a member of the Geriatrician-Led MDT for frail (CFS 5+) patients 65 or older” to &amp;gt;80% (Green: ≥80%, Amber: 50 – 79% Red: &amp;lt;50%) of estimated 100 patients per year. Methods 1. Proactive case finding with general surgical teams; 2. Engagement with Emergency Surgical Committee and NELA leads; 3. Improved our own electronic referral system; 4. Assist in development of electronic booking system with emergency laparotomy cases Results We showed a significant improved in meeting the NELA standard from the red zone (Mean: 33% range 5% to 35%) into the amber with a of mean 60% (quartile range 52% to 78%) but still remains below our target with significant quarterly variation seen. All referrals and assessment remain post-intervention. Limitations in measures: Conclusions Following a number of change ideas and despite challenging COVID related staffing issues we showed that a combination of key stakeholder engagement, proactive case-finding and improved referral processes we have improved Geriatrician input in frail patients undergoing emergency laparotomy. We suspect due to the non-systematic assessment of frailty that we may be missing some patients and or seeing late in care pathway.

Modern electronic booking and reservation systems in the hotel business

The article examines the peculiarities of the implementation of information technologies in the hotel enterprise. It was established that the use of modern information technologies becomes a means of competitive struggle in the hotel business. The guest service process begins with his contact with the reservation service, which forms the first impression of the hotel. Therefore, the quality of the provided hotel services plays a major role in increasing the rating among accommodation establishments and in attracting new customers. However, the majority of accommodation facilities do not have a sufficient level of equipment for customer service using automated systems, the accommodation facility's own mobile applications and various modules with the effect of partial contactless and quick service. The terms «hotel reservation system» and «reservation system» are often used interchangeably in the hospitality industry, but they are actually different things. A hotel reservation system, or CRS, is the central hub where booking information is stored from all booking channels, whether by phone, OTA, GDS, sales force or online booking system. A website booking engine, called an Internet Booking Engine (IBE), is software that allows guests to make reservations directly from the hotel's website. Today, most hotels have switched to a digital reservation system, while a significant number of small hotels, hostels, hotels, guesthouses, and rental companies still use manual processes. This puts them at a disadvantage compared to their more technologically advanced competitors. It was determined that electronic reservation and reservation systems are the most important sales channels for the hotel enterprise. A general review of electronic booking and reservation systems in hotels was conducted. A mobile application is a new innovative idea for hotels, which helps to improve the process of booking rooms in accommodation facilities. The application allows the client to choose a language convenient for him, which will greatly simplify the process. There are many free mobile applications that also excel in modern automated booking systems. Mobile services on Android and IOS will give accommodation establishments several serious advantages over competitors, and customers will quickly search for personal orders on them. Booking (App Store, Google Play) is the most popular search program and accommodation reservation. Its feature is free booking and the possibility to pay for accommodation directly upon check-in. HotelsCombined (App Store, Google Play) – an application with extensive information on prices for hostels and hotels of higher categories on various booking services. Hostelworld (App Store, Google Play) is a convenient service for booking accommodation (hotels, rooms, apartments). Airbnb (App Store, Google Play) is a server for renting a separate apartment or apartment. HotelsGuy – this reservation system application is suitable for tourists who want to save on accommodation; is popular among young people in many countries of the world. Current hotel automation systems were analyzed and the most popular advantages of reservation systems were determined. Each hotel has its own standards of operation of the reservation service, but the goal is the same - to maximize the loading of the room fund. Modern computer technologies make it possible to make reservations very quickly and automatically enable the employee making the reservation to receive timely and comprehensive information about the guest, his tastes, habits, and preferences. Room reservation is quite often of decisive importance for choosing a particular hotel. With this in mind, all stages are important in the booking process.

Sistem Informasi Log Book Harian Peserta Magang Pada Dinas Kominfo Kota Semarang

Log book is a record book of important events in the management, operation, and navigation of ships. In simple terms, the log book is used by apprentices to record daily or daily / time activities carried out during internships. It can also train apprentices to be disciplined and orderly to record information related to improving the skills of apprentices in the field. The use of the daily log book of apprentices within the Ministry of Communication and Informatics is intended for daily reporting of the activities that have been carried out by apprentices as well as a data recap for the Office of Communication and Information Technology in evaluating whether the learning activities provided are in accordance with the needs of the apprentices or not. By utilizing the website application as an online medium, it will help the reporting process go faster. The electronic log book system has the advantage that research activities can be monitored at any time. The software development method used is waterfall which is built using the PHP programming language, CSS and Bootstrap Framework, as well as database processing using MySQL. The method of testing is done by blackbox, namely testing is done by testing the software in terms of functionality. The results of the research, namely the Internship Diary Log Book Information System at the Semarang City Communication and Informatics Service can help interns to make reports quickly.

133 A Quality Improvement Project to Improve the Appropriateness of Acute Clinic Referrals to a Local ENT Department Using an Electronic Booking System

Abstract Aim Assess and improve the proportion of inappropriate acute clinic referrals being made to our local ENT department via a telephone referral system with regards to nature and suitability for a junior grade doctor run clinic with senior supervision. Additionally, to make a more efficient, timely and failproof booking system with an auditable trail by transitioning to an electronic referral system. Method A guideline was created using based on common protocols from major Trusts within the UK which was then used to assess 101 acute clinic referrals taken from February 2021 to our local service. An electronic referral system was created, and guidelines disseminated to departments commonly making referrals to the acute clinic in anticipation for re-audit in September 2021 alongside introduction of the guideline to new doctors rotating to the specialty at induction in August. Results Initial audit revealed 29% of referrals were inappropriate, 50% of which were too complex, 45% were not acute and 5% were due to accidental double-bookings. Additionally, nasal fracture reviews were seen within 10 days only one third of the time, 37% of patients referred did not have a recorded contact number and 13.8% of all referrals were made with incorrect or unclear clinical information. Conclusions The lack of clear clinical guidance on referrals to an acute ENT service at our local centre with an outdated telephone referral system is associated with a large proportion of inappropriate referrals, delays to timely care and transcription errors potentially putting patients at risk of harm.

Current Trends in the Application of Innovative Technologies in the Tourist Field

The article analyzes the current trends in the use of innovative technologies in the field of tourism. The essence of innovative technologies in tourism and their role in the development of tourism is determined. It has been found that innovations in tourism are the creation of a new or improvement of an existing product using the latest techniques, technologies and resources. It was found that in the field of tourism the use of modern information technologies is relevant, in particular: mobile Internet; electronic catalogues with leisure offers; electronic booking systems; social information networks; electronic ticketing systems; Internet advertising; convenient payment systems, etc. It is established that Internet technologies are an effective means of forming a positive image of the enterprise; promotion of new types of tourist services; informing consumers about new tours or promotions, as well as promoting them on the market, etc. Examples of modern innovative technologies used in the field of tourism are given and the expediency of their introduction is proved. It has been found that in modern conditions it is important to visit online museums and virtual 3D tours, which allow you to travel via the Internet. It is proved that social information networks are an effective tool that affects the consumption of tourist services. They allow tourists to share their own tourist experience, impressions of hotels, level of service and more. It was found that at the present stage of tourism development it is important to form and effectively operate a system of innovation management. The necessity of the development of the newest directions of Internet marketing in the field of tourism is proved. It is established that the introduction of innovative technologies ensures the effective development of the tourism sector in modern conditions, as well as gives a significant competitive advantage.

Digital first during the COVID-19 pandemic: does ethnicity matter?

The UK's strategy to control COVID-19 has seen reliance on digital technologies, including electronic booking systems for testing and vaccination and a National Health Service COVID-19 app to support the National Health Service's Test and Trace programme. During the pandemic, the UK Government has invested heavily in digital technologies, with the design and implementation of the Test and Trace programme alone estimated to have a projected cost of £38 billion.1

The effects of inter- and intraorganizational factors on the adoption of electronic booking systems in the maritime supply chain

Digitalization is currently reshaping business models and providing more opportunities for cross-border supply chains. Maritime transportation occupies a crucial position in the global supply chain and information systems are playing an increasingly important role in the industry. In contrast with information systems used in other industries, interorganizational information systems in the maritime industry may involve a greater number of organizational users, including manufacturers, customers, shipping lines and customs and port authorities from different countries. Therefore, the adoption of container e-booking systems in the maritime supply chain is complex and with limited scrutiny in academia. This study explored the use of e-booking systems in the maritime supply chain and, in particular, the factors influencing the adoption of such systems at the organizational level. The study aimed to close the gap between the general understanding of the adoption of information systems and the adoption of e-booking systems in a specific context, namely the maritime supply chain. We conducted an exploratory multi-case study of eight firms across multiple tiers of the maritime supply chain. We employed a qualitative approach to investigate this issue at the maritime supply chain level, rather than the firm level. The study focused on inter- and intraorganizational factors. The results suggest that adoption is influenced by several factors, including pressure from trade partners, pressure from leading organizations, as well as organizational compatibility, and so forth. Furthermore, the identified factors have different levels of impact across organizational tiers in the shipping chain. This study offers insights that are relevant to both researchers and practitioners in the maritime transportation industry and may help to accelerate the digitalization of the industry.

Actor-network relations between consumer and provider in tourism on Lake Baikal

The authors consider actor-network relations in the interaction of providers and consumers of tourist services in the Baikal region, where tourism is integral to environmental management and sustainable development of the territory. The paper emphasizes the need for environmental management with a due regard to all stakeholder of the consumer-provider interaction system. The research method involves application of an actor-network approach. Using this approach allows us to identify not only “live” social networkers, but also other intermediaries who are not people. Currently, consumers of tourist services do not particularly need live intermediaries; their role is performed by non human intermediaries - wires and computers. The paper examines the role of information and communication technologies, tourist databases, transport, electronic booking systems, communication tools, and social networking in this relationship. The authors highlight that the development of tourism supports the local economy, which contributes to the sustainable development of the territory, but the linkage formation between the consumer and provider of tourist services is complicated by a large number of intermediaries Thus, it is surmised that the development of information infrastructure should be accompanied, or rather preceded, by the development of all other infrastructure elements (water supply, waste disposal and transport development). It was revealed that, the more connections and their diversity between a tourist camp and a potential tourist, the higher its stability and competitiveness, which can contribute to the sustainable development of the tourism industry in the Baikal region.

The effect of the introduction of an electronic booking system to appropriately prioritise gastroscopies at a regional hospital in South Africa.

The National Institute for Health and Clinical Excellence (NICE) guidelines state that patients with dyspepsia as well as alarm symptoms, or those that are 55 years and older with new onset dyspepsia, urgently require an upper endoscopy within two weeks. The 'Be Clear on Cancer Campaign' launched by Public Health England estimated that 9% of deaths due to gastric and oesophageal cancers could have been avoided if the diagnosis was made at an earlier stage. Worcester Provincial Hospital (WPH) is a regional hospital in the Western Cape, South Africa, that due to resource constraints was unable to comply with these guidelines. An electronic endoscopy booking system was implemented in June 2014 to assist referring clinicians. To evaluate the ability of the booking system to appropriately prioritise and accommodate clinically appropriate patients for an urgent gastroscopy within 2 weeks at WPH. Retrospective analysis of patients booked for urgent gastroscopies using the online booking system at WPH from July 2014 to June 2017. A total of 1589 gastroscopies were performed, with 1085 (65%) categorised as urgent by the booking system algorithm, during the study period. The median (interquartile range) waiting time for urgent gastroscopies was 19 (8 - 31) days and 437 (40%) patients underwent a gastroscopy within the recommended 2-week period. Of the patients undergoing gastroscopy within 2 weeks, 87 (20%) were diagnosed with upper gastrointestinal malignancies and 73 (17%) had significant benign pathology (stricture or ulcer). A total of 150 malignancies were diagnosed in the urgent patients of whom 87 (58%) were scoped within 2 weeks. The volume of patients requiring urgent gastroscopy at WPH outstrips the available resources. The introduction of the online algorithm-based booking system was effective in prioritising patients. The use of this system facilitated a malignancy diagnosis rate which compares favourably with similar fast track endoscopy services in more developed countries.

Implementation of an electronic booking system for emergency surgery

A survey completed by operating theatre/operating room (OR) teams showed that a paper-based emergency surgery booking system was not fit for purpose, resulting in poor situational awareness. A business case was created for the purchase and implementation of an electronic system for a UK acute NHS hospital. As a result of the change, OR staff, surgeons and anaesthetists had significantly heightened situational awareness. While they faced a number of challenges, users felt that an electronic system was overall advantageous.

PROBLEMS OF THE FORMATION OF THE UNITED EUROPEAN TRANSPORT SPACE

Topicality. The relevance of the study is based on the fact that the transport sector of the European Union is at a crossroads today, as it requires a policy that meets the needs of the 21st century and which will contribute to the growth of jobs in the EU. It must avoid constraining mobility, while at the same time responding to a range of social and economic problems that arise. Aim and tasks. The purpose of the article is to develop theoretical, methodological and practical applications, which should justify the optimization of transport services and changes in the design of vehicles and infrastructure of the European Union. In addition, various factors of historical and geographical nature often affect the political merits of States parties. After decades of EU activity, there is currently not a sufficiently compatible and resource saving network of interconnected, trans border transport infrastructure. Reasearch results. The essence of the formation of a united European transport network is the implementation of direct links between the main nodes and the infrastructure that forms the mobility of passengers. Airports, ports, railways, undergrounds and bus stations must increasingly be transformed into multimodal communication platforms for passengers and cargo. Online information, electronic booking and payment systems that combine all vehicles will contribute to multimodal travel. But today legal, administrative and technical barriers multiply and slow down the process of forming a single European transport space. Despite the intensification of rail freight and international passenger transport, access to the transport services market continues to be a serious problem. This is largely due to lack of independence and lack of financial transparency between infrastructure managers and service providers, which can lead to discrimination and distortion of the market. Conclusion. The transport policy of the European Union provides a powerful lever for economic recovery. A new issue for European transport systems is their intermodality, that is, the opportunity for logistic chains to use different consecutive modes of transport according to their specific needs for optimizing costs and environmental impact. This means the implementation of regular, clear efforts at European level country by country, industry by industry, according to different geographical, economic and historical features. An investment strategy in transport infrastructure will make sense only if it is shared by actors in the world market. By means of joint financing of individual objects by business and states, the possibility of creating a single European transport network will be real.

An integrated approach to demand and capacity planning in outpatient clinics

An outpatient clinic serving two independent demand streams, one representing advance booking requests and the other same-day requests, is considered. Advance requests book their appointments through an electronic booking system for a future day, and same-day requests are served on the day they arise. A compact policy formulation is proposed that incorporates major operational levers suggested in the literature. It combines a slot publication policy, which specifies the pattern under which slots are released to the booking system, with an expediting policy that adjusts the daily workload of advance patients. Relying on a wide range of numerical experiments, a heuristic search method is developed for finding the joint publication and expediting policies, minimizing the cost of overtime slots whilst ensuring a waiting and an access constraint is met. Several managerial insights are derived using a combination of illustrative and real data, highlighting the importance of taking an integrated approach towards the operational levers captured by our policy formulation.

Choosing and booking-and attending? Impact of an electronic booking system on outpatient referrals and non-attendances.

Patient non-attendance can lead to worse health outcomes and longer waiting times. In the English National Health Service, around 7% of patients who are referred by their general practice for a hospital outpatient appointment fail to attend. An electronic booking system (Choose and Book-C&B) for general practices making hospital outpatient appointments was introduced in England in 2005 and by 2009 accounted for 50% of appointments. It was intended, inter alia, to reduce the rate of non-attendance. Using a 2004-2009 panel with 7,900 English general practices, allowing for the relaxation of constraints on patient of hospital, and for the potential endogeneity of use of C&B, we estimate that the introduction of C&B reduced non-attendance by referred patients in 2009 by 72,160 (8.7%).

The true malignancy rate in 135 patients with preoperative diagnosis of a lateral neck cyst.

ObjectiveIn this study, the true malignancy rate in 135 patients with a preoperative tentative diagnosis of a lateral neck cyst (LNC) was assessed. Furthermore, the sensitivity and specificity of fine needle aspiration of suspected LNC were evaluated and the diagnostic delay was analyzed.Study DesignThis study was retrospective in design and included all patients who had undergone surgery for a suspected LNC in four secondary hospitals in the eastern regions of Denmark during the period of 2009 to 2012.MethodsOne hundred thirty‐five patients were identified and included by means of a search strategy for NOMECO surgical procedure codes KENB40A+B in the electronic surgical booking systems. Because the procedure codes also include median neck cysts and fistulas, the latter were excluded manually.ResultsOf the 135 patients preoperatively diagnosed with LNC, a malignant postoperative histopathological diagnosis was revealed in 19 patients (14.4%). Of these, three individuals were between 35 to 40 years of age. In 17 cases, preoperative fine‐needle aspiration biopsy showed benign cytology, whereas histopathology postoperatively proved to be malignant. This renders a sensitivity of 88.8% and a specificity of 60.0% for fine needle aspiration biopsy with regard to LNC diagnostics.ConclusionThis study suggests that, for patients older than 35 years, a cystic lateral neck mass should be considered potentially malignant; by contrast, LNC is a diagnosis of exclusion. Any delay in treatment should be avoided until final histopathological diagnosis has been obtained. Arguably, all patients older than 35 years with a cystic lesion laterally on the neck should be included in the fast‐track cancer referral program.Level of Evidence2b.

P02.02 Another digi-gap! integrating multifaceted triaging approaches to assist and speed technological transition to electronic medical documentation and booking systems

<h3>&nbsp;Introduction</h3> Recognising and harnessing cultural and technological shifts in both client and healthcare provider arenas are crucial to optimising clinic wide responses to STI education and care. As methods of client-to-service engagement evolve, healthcare providers and their documentation systems must change as well. This is crucial to optimising clinical care and interaction for potential sexual health clients, especially when incorporating mandatory area health service and ministry directives into daily practice. Northern Sydney Sexual Health Service (NSSHS) triage has long allowed for telephone and walk-in enquiries. NSSHS has modified the existing service website to allow for online booking enquiries. This allows a potential patient to perform basic self-triage while engaging with sexual health services in a safe, non-confronting manner. At the same time, this reduces telephone wait times for clients and improves engagement. <h3>Results</h3> 75% of all website enquiries are appropriate for Clinic 16 services. A significant increase in appointments made via our website enquiry system for priority populations has occurred since initiation in November 2014, including with men who have sex with men (MSM) and youth. By improving our priority population engagement, there is a marked improvement in Occasions of Services and a projected improvement in Activity Based Funding (ABF) capture via the new electronic medical record system, Community Health and Outpatient Care system (CHOC). <h3>Conclusion</h3> By integrating a multi-platform approach to patient engagement, NSSHS is growing to fit client needs while incorporating Local Health District and Ministry of Health mandated electronic medical record changes. This improves ABF capture, patient documentation and above all, improves engagement of priority populations with sexual health services. <h3>Disclosure statement</h3> Northern Sydney Sexual Health Service is funded by the Northern Sydney Local Health District. No grants were received in the development of this study or project.

G541(P) Improving the efficiency of procedure lists in paediatric haematology-oncology - a quality improvement project

<h3>Background</h3> Childhood cancer incidence is increasing in the United Kingdom with an average of 1574 new cases diagnosed per year. Bone marrow aspiration and delivery of intrathecal chemotherapy are routine procedures in paediatric haematology-oncology. National Institute of Clinical Excellance (NICE) Improving Outcomes in Children and Young People with Cancer acknowledges the importance of dedicated theatre slots to reduce delays in diagnosis and therapy. To ensure high quality safe patient care efficient organisation and smooth running of procedure lists is paramount. <h3>Context</h3> This Quality Improvement Project was carried out in the Paediatric haematology-Oncology department of a tertiary oncology hospital over 5 months. It involved oncology doctors, the anaesthetics, oncology day care nurses, theatre staff, porters and laboratory staff. <h3>Problem</h3> There were frequent delays in starting the list and interruptions resulting in the list overrunning causing staff and patient dissatisfaction and late arrival of bone marrow and lumbar puncture samples to the laboratory. <h3>Assessment of problem and analysis of its causes</h3> Meetings with stakeholders were held to discuss the current status, identify obstacles and possible solutions. An initial audit over one month was performed to identify the start and finish times and document the reasons for delay. The audit highlighted the following: Inadequate training and use of staff resources. Poor time management Inadequate booking system for appointments Late sample delivery to the laboratory <h3>Study design</h3> This was a qualitative observational study with analysis of pre and post interventional audit results. <h3>Intervention and Strategy for Change</h3> Multidisciplinary communication with various stakeholders was key in agreeing common goals to improve efficiency and quality of the current theatre list. Using a Plan-do-Study-Act Cycle changes were gradually introduced over the next 4 months. The teams were updated by regular weekly emails and monthly meetings to discuss the next steps. Staff Resources: Rota allocation to ensure optimal junior medical staff cover on the procedure days to allow prompt start. Improved training of doctors and allocating two doctors to a procedure list, one of whom is an experienced senior doctor who can provide immediate assistance to the junior colleague. In addition an Advanced Nurse Practioner has been appointed to start a nurse led service. Improved communication with anaesthetic collegues and availability of their contact details. Time management: Inter-patient delays were approached by improved co-ordination amongst the recovery and day care nurses and patient transport strategies. Booking system: With increasing patient numbers it was essential to have an improved electronic booking system. An appointment scheduler giving staggered appointment times would be introduced. Pending this, patients were encouraged to arrive before 10 am and have necessary investigations done in time prior to their procedure. Sample delivery: Introduction of specific porters for timely collection of samples enabling quick diagnosis of new oncology children. Re-organisation of the procedure order so that diagnostic bone marrows are first on the list. <h3>Measurement and effects of change</h3> Descriptive statistics was used and nominal variables calculated as percentages. The results are:- 85% reduction in late finish and cancelled procedures 100% of the samples delivered to laboratory by 5 pm 80% improvement in availability of pre-procedure blood results Improved training of doctors and team morale <h3>Lessons learnt</h3> Inclusion of patient satisfaction surveys would have enabled us to include their views and make modifications to the service. <h3>Message for others</h3> Good planning with adherence to SMART objectives is essential Early involvement of stake holders and agreement on common goals To ensure sustainability we involved the permanent day care nurses and senior managers.