AB127. SOH25_AB_075. Impact of the development of the University Limerick Hospital Group pain excellence centre

Background: Lack of timely access was impacting on University Hospital Limerick (UHL) Pain Management services. The waiting list in 2021 was 904 with a wait-time of 196 weeks. Outpatient services reviewed 1,504 patients annually with 30% of these new patients. Despite 1,500 pain procedures being performed annually, there was still a wait time of over one year for intervention. Ninety-eight non-elective procedures were carried out in outpatients due to unmanageable pain crisis of patients attending the clinic. This resulted in a loss of potential income of €354,933 for 2019.

Methods: PESTLE and SWOT analysis of current service process identified bottle-necks within service provision. Through environmental scanning and the performance of due diligence, one was able to identify and evaluate strategic options and set objectives towards a change in strategic approach enabling growth. A business case was formulated identifying the proposed reconfiguration of services within the proposed areas. This would create a leaner process flow while encompassing the quadruple aim. The business case was pitched at executive level and approved.

Results: Development of the Pain Management Unit has improved efficiency. Wait-time has reduced from 196 to 23 weeks from referral to review. Time to pain intervention has reduced from 60 to 12 weeks from review time with the ability to facilitate larger lists. Emergency procedures can now be facilitated in day-theatre immediately following assessment in outpatient clinics through transfer.

Conclusions: Lean process innovation enabled improvement in quality patient care and has allowed for the expansion of services to meet societal needs.

Keywords: Centre; lean; outpatients; pain; waiting-lists