G66(P) Improving care of LTV children: use of RAG approach for effective workload management

Background and aims The paediatric long-term ventilation (LTV) team is responsible for the care of 231 children, 75 of these children are having long-term ventilation including invasive tracheostomy ventilation and non-invasive mask ventilation. The team receives enquiries from parents and community team during the week, there is additional workload from jobs created from clinic reviews, discussions in virtual clinic and clinical reviews of these children. To deal with the jobs more efficiently and to ensure that all jobs are undertaken aptly, we designed a red amber green (RAG) approach to manage these jobs. We present the data on our experience in using the RAG approach in managing our workload over the last 16 months (May 2017- September 2018). Methods All jobs for the LTV team were noted in the LTV database, all team members had access to this database. All pending jobs were initially red; these were turned to green when completed. Data on pending jobs and whether jobs were completed aptly, and staff satisfaction were collected. Results A total of 381 jobs were noted in LTV database from May 2017 to September 2018. 84 oximetry results were chased. 45 repeat oximetries, 11 polysomnographies and 18 capnographies were arranged. Results of 140 respiratory samples were chased, 43 children were thereafter started on antibiotics. The above results and management plans were discussed with parents. Clinical reviews were arranged for 21 children. 74 community referrals were sorted. 10 referrals to other specialties were done. 15 repeat prescriptions were sent. 11 Respiratory emergency management plans were updated. RAG approach ensured that all jobs were completed timely and appropriately, weekly reviews of the database helped ensure that the team was up to date with the pending jobs. There was improved staff satisfaction with the RAG approach. Conclusions The LTV team coordinates the care of children with complex respiratory issues and has high workload with varied issues including chasing pending results, organising investigations, starting medications and arranging clinical reviews. The RAG approach helped the LTV team to better organise the workload, pending jobs were completed timely and aptly and this improved both parental and staff satisfaction.