FRI0688 Fast access to assessment support and treatment (FAAST): innovation to improve service

• Published in: Annals of the rheumatic diseases Vol. 77; no. Suppl 2; p. 863
• Main Authors: Laxminarayan, R., Dean, A., Bembridge, L., Redfern, S., Nutland, H., Nisar, M.
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group LTD 01.06.2018
• Subjects: Intervention; Patients; Therapists
• ISSN: 0003-4967; 1468-2060
• DOI: 10.1136/annrheumdis-2018-eular.4478

Background:Physiotherapy is integral to rheumatology MDT. Early physiotherapy interventions optimise education, self-management and enhance outcomes. Delay in first physiotherapy assessment leads to non engagement, altered clinical features and adverse outcomes1. Our physiotherapy service provided appointment based assessments. Each new patient appointment was for 60 minutes. We had an average of 43 day wait to see routine patients. Non attendance rate was high, patients did not value the benefits of physiotherapy and therapist was not able to provide input in patient management.To improve service, a new system of Fast Access to Assessment, Support and Treatment (FAAST) was introduced in April 2017, allowing patients same day access to physiotherapy on the day of referral.Objectives1. To assess the impact of FAAST on non-attendance rate and subsequent visits.2. To analyse the type of interventions, time spent on assessment and benefits on resource utilisation.Methods:Patients completed a body chart to document their symptoms and a baseline Burton-Patient Reported Outcome Measure (B-PROM)2,3. These informations allowed the therapist to assess patients’ priorities. Physiotherapist and patient then decided upon the appropriate and possible intervention on the day and subsequent visits. Follow up appointments were made based on clinical need and patient's convenience. We collected data prospectively on type of intervention, time spent on assessment, attendance to subsequent sessions and compared to the data from conventional physiotherapy clinics.Results:FAAST project started in April 2017. This ran parallel to the conventional clinic. Now it is the main portal of referral to physiotherapy. We present data from April 2017 to November 2017. 495 out of 952 patients referred in this period were assessed in the FAAST clinic.1. Average wait time in conventional clinic was 43 days for routine and 19 days for urgent. In FAAST clinic, every patient was assessed by the physiotherapist on the day of referral eliminating waiting time. Average time to second review after FAAST clinic was 23 days.2. Type of assessment was decided on the first visit to FAAST clinic. About 70% patients were booked for one to one sessions and about 15% were booked into group sessions designed for specific disease conditions. FAAST assessment helped to identify patients needed to be referred to other specialist therapy areas also.3. Non-attendance rate for the first appointment in conventional clinic for preceding three year period was 13%. Every patient referred to FAAST clinic attended the first appointment and non-attendance at second appointment improved to 9.5%.4. Average time spent by the therapist at first FAAST clinic was 29 minutes which equated to saving of 242 hours compared to conventional clinic. Pre FAAST era, 100 new patients were seen a month on an average. Since FAAST clinic started, this increased to 136 a month.Conclusions1. FAAST clinic achieves its objective of reducing waiting times and non-attendance rate.2. Average assessment time was flexible, saved time and helped to improve efficiency of the clinic.3. Assessment and intervention on the day of assessment helped to target the therapy more effectively.References1. doi:10.1186/1471-2474-14-2032. doi:10.1136/annrheumdis-2016-eular.59263. doi:10.1136/annrheumdis-2016-eular.4670Disclosure of Interest:None declared