Case Study
Warrington and Halton Hospitals NHS Foundation Trust
Putting patients at the heart of phlebotomy booking services
Transforming Phlebotomy Appointment Booking Services
This case study describes how Warrington and HaltonNHS Foundation Trust (WHH) has implemented WASP’s Online Patient Booking Solution for Phlebotomy Appointments to transform the service offered to GPs and patients for phlebotomy appointments.
The Trust is reporting high levels of patient engagement and satisfaction whilst supporting quality improvement in blood sciences, and sustainability programmes in primary care.
We're not doing the same things better,
we're doing better things.
Key Features and Benefits
• High levels of patient engagement. 92% patients opted to book online during the initial service pilot. Additionally, patients are not expected to present at clinic with their GP order paperwork, relieving patients of responsibility of collecting paperwork from the practice, especially if they were referred during a remote consultation.
• Booking made easy. Patients receive a text message with a booking link, with access to schedules restricted to patients who have an open order. Users simply select the most convenient appointment slot. Patients who prefer to book over the phone can still do so as Trust call centre staff also utilise WASP’s scheduling service to identify and book appointments.
• Intelligent appointments. WASP Software’s unique scheduler displays available appointments within clinically relevant timeframes.
• Sustainable, paperless blood test requests. GPs order blood tests digitally, removing the need to print blood test request forms. With WHH estimating an annual requirement for 330,000 blood tests a year, this represents a significant benefit for GP practices in terms of reducing paper and print use as well as reducing secure document waste disposal costs.
• Improving quality in blood sciences. At WHH, WASP’s scheduler software works in conjunction with the Compugroup Medical (CGM) MOLIS Laboratory Information Management System to enable efficient identification of required tests and tubes when the patient presents in phlebotomy and notifies the patient when their blood samples arrive at the laboratory for processing.
Introduction
Warrington and Halton NHS Foundation Trust has deployed WASP’s Online Patient Booking Solution for Phlebotomy Appointments, allowing patients to book phlebotomy appointments at a time and location that suits them.
WASP Software is a specialist developer of healthcare solutions. Through an intimate knowledge of NHS processes, procedures and patient pathways, WASP has deployed system-agnostic scheduling solutions across a wide variety of NHS providers.
Our positive experience of working with WASP on NHS111 referrals management, coupled with the fact that WASP Software are one of the very few companies to offer a BaRS compliant solution (the new booking and referrals standard) meant that they were an ideal partner to deliver a phlebotomy patient self-service solution for the Trust.
Chris White
Head of Enterprise Solutions, WHH
How it works
The phlebotomy booking service at Warrington and Halton NHS Foundation Trust integrates with the Trust’s GP Pathology Ordering System and Electronic Patient Record (EPR) to issue a unique link to the Trust’s online phlebotomy schedules, hosted on WASP’s Cloud service, via a SMS text direct to a patient’s mobile.
Explains Chris White, Head of Enterprise Solutions, WHH: “When a GP places an order for a blood test, the order goes into MOLIS (the Laboratory Information Management System) and also goes across to WASP. The patient will now receive a text message allowing them to make a booking that they manage themselves.”
Booking made easy
The patient receives a text with a booking link as well as the Trust’s call centre phone number. By clicking on the link, the patient is connected directly to the service and is able to choose a convenient location and time for their phlebotomy appointment.
Importantly, patients can also manage their booking from the original link in the text so if they need to cancel and reschedule, it’s easy for the patient to do this.
In addition to sending booking reminders and appointment confirmation messages, WASP makes it easy for patients to manage their appointments. This helps to free up appointment slots for other patients and to reduce DNAs in phlebotomy.
Michael Brett
Managing Director, WASP Software
Improving quality in blood sciences
Within clinic, the WASP service provides an Expected Patient Screen that allows the phlebotomist to call patients, match blood tubes to orders and record attendance.
To do this, WASP’s scheduler software works in conjunction with MOLIS, the Pathology Service LIMS. This enables efficient identification of required blood tests and tubes when the patient presents in phlebotomy. By scanning the WASP generated QR code (using a mobile device enabled version of MOLIS), detailed sampling instructions are retrieved from MOLIS. Phlebotomists simply scan the necessary barcoded blood tube(s), which associates the tube with that order. When the tubes arrive in the lab, the barcodes are scanned, and the order is identified.
Whereas historically some patients may arrive with multiple paper test request forms which would need manual checks, the new service is helping to reduce errors by identifying the required tests and the correct blood tubes required for each test.
Our customers said:
The whole process has been designed to work brilliantly even when something goes wrong. For example, if the patient completely forgets to book, the GP gets notified that the requested test was never taken up. This feedback to the GP supports better patient care and the laboratory can close the request. This is a significant step forward.
Fred Hilger
Product Manager, MOLIS LIMS, Compugroup Medical
Optimally equipped for all scenarios
What if....
- a patient forgets to book?
- needs testing in a specific timeframe?
- turns up at phlebotomy without an appointment?
WHH, WASP Software and CompuGroup Medical (CGM) worked collaboratively to secure a phlebotomy process that runs smoothly in all eventualities.
If timing is an issue, WASP will only offer appointments that are within the window requested by the GP.
If a patient arrives at phlebotomy without making an appointment, WASP will use the order number linked to the patient to update the system to show that the patient has been tested. This will cancel any further reminders to book.
We wanted to build the process in a way that copes with exceptions such as a patient who arrives needing an urgent test who has not had chance to book. WASP matches this up with the GP order.
Chris White
Head of Enterprise Solutions, WHH
About the pilot
During the pilot, GPs selected for 92% of patients to be sent the option to book online, with nearly 7,000 appointments processed in just over 4 months.
Patient feedback has been extraordinarily positive, with reports of patients leaving their GP, receiving a text, booking their appointment online and being bled within minutes.
Having been successfully piloted at two GP practices, WASP’s phlebotomy booking service is being rolled out to all GP Practices in the Halton and Warrington area in 2024.
Trust Feedback
The trust is equally positive with the Chief Operating Officer reporting that it has taken away some call centre traffic and improved call access times despite being at reasonably low pilot levels. It is predicted that this improvement will continue exponentially, especially if the vast majority of patients continue to book online themselves.
Patients like the convenience of being able to select their appointments – and to be able to easily manage that appointment. As soon as a GP has requested a blood test, WASP sends out a text message to the patient with their unique booking link. If they don’t book, we will send them a reminder as well as a confirmation when they do book. This reassures patients that their booking has been made.
Michael Brett
Managing Director, WASP Software
Closing the loop for all patients
When fully deployed, it is anticipated that the WASP booking service will be managing appointments for approximately 330,000 blood tests annually.
A key benefit of the patient self-service application is that all blood test orders are now closed, meaning only patients who have an open order are able to book appointments. Additionally, the service is able to proactively monitor demand, review orders with/without bookings and react by allocating resources to areas of most demand.
If a patient does not attend their phlebotomy appointment, or does not book an appointment, the GP is automatically informed to enable them to follow up.
The process also accommodates the needs of patients who do not want to book online. Patients are provided the call centre number in their text message or at their practice if they do not have a mobile phone or tell their GP that they don’t want to book online.
Call centre staff use the same WASP schedules to take patients through the same options of where and when they would like their blood test..
Other benefits linked to deploying WASP’s phlebotomy booking service include:
Sustainability improvements. Paperless blood test requests are dramatically reducing printer toner and paper use in General Practice as well as a reducing the volume of confidential paper waste disposal by the Pathology Service.
All orders are placed online by Primary Care and there is no requirement for the patient to take any paperwork to clinic with them. This is particularly relevant for patients who have had a remote consultation with their GP – they don’t need to visit the practice to pick up their order form.
Reduced duplications. Previously GPs would generate multiple orders and print multiple forms for patients which could result in duplicate testing. The phlebotomy booking process has radically reduced the potential for duplication.
Reduced call centre demand. Feedback from call centre staff has been positive. Piloting the service at only two GP practices resulted in a noticeable fall in call centre volumes. Call Centre staff also report that the WASP scheduling solution is very easy to use.
Then and now: Phlebotomy drop-in to an appointed service
Before the COVID-19 pandemic, WHH phlebotomy operated as a drop-in service across multiple sites at Warrington and Runcorn Hospitals as well as delivering phlebotomy services to wards and various clinics and children’s outpatients.
Patients would simply come to the phlebotomy room with a paper blood test request form from their GP.
Neil Gaskell, Pathology Manager, WHH explains: “Typically, patients would come at first thing in the morning. There would be a long queue, and many would be unhappy about waiting for their test. With the pandemic, we had to initiate social distancing, so phlebotomy became an appointed service. Implementing appointment slots was a better service because when the patients arrived, they didn’t have to wait, they just came in for their appointment, had a quick test and left.”
During the pandemic, phlebotomy test appointments were booked via the Trust call centre. This had a huge impact on the available infrastructure and call centre staff as call volumes escalated. Patient complaints increased and a radical change of approach was needed.
In addition, the Pathology Service was contacted by a GP practice that wanted to explore ways to reduce the need for printed blood test request forms as part of a sustainability initiative.
Meanwhile, the Blood Sciences Department was receiving high volumes of test request forms from GP practices with poor quality print. This, coupled with the use of specimen tubes that required manual labelling, was causing operational issues, and affecting the quality of samples processed by the laboratory.
Neil explains: “From a quality improvement perspective, we wanted to transition the phlebotomy service to using pre-labelled blood tubes to reduce issues with handwriting and mislabelling. With a team of over 50 phlebotomists, errors could have a big impact on the lab in terms of efficiency as well as the patient as they may need to be re-called for another test.”
The Trust’s LIMS provider, Compugroup Medical, developed an app that would enable the use of pre- labelled blood tubes. Explains Neil: “The app is really clever, linking the correct colour collection tube to the patient so the correct tube is always used. All the phlebotomist now has to do is write the patient’s name on the tube. By working with CGM we had found a solution that would allow the use of pre-labelled tubes. What we didn't have was a connecting piece for our patients - this is where we needed WASP Software.”