Cambridgeshire Lifespan Autism Spectrum Service Clinic: Managing Demand, Capacity and Flow of Referrals for Adult Autism Assessment

• DOI: 10.1192/bjo.2024.423
• Publication Date: 2024-08-01T10:05:53Z
• Authors: Janine Robinson; Jasmine Taylor; Mark Squire; Andrea Woods; Irene James
• Keywords: Psychiatry; 03 medical and health sciences; 0302 clinical medicine; 3 Quality Improvement; RC435-571

Aims Referrals for adult autism assessment to the Cambridgeshire Lifespan Autism Spectrum Service (CLASS) have increased from 430 in 2019 887 2023, with demand exceeding capacity. The team enrolled Royal College of Psychiatrists’ Quality Improvement (QI) Demand, Capacity and Flow (DCF) Collaborative. agreed aim was increase number diagnostic assessments by 51% per month. Methods Participants included CLASS multi-disciplinary (MDT), referrers, provider improvement advisor an autistic adult. Using NHS Redesign (QSIR) six-step approach, a process map identified five key stages pathway. A project driver diagram then used identify change ideas referral, screening, pre-assessment, post-diagnostic stages. Change screening were prioritised two Plan-Do-Study-Act (PDSA) cycles designed: PDSA 1) To reduce time removing first referrals; 2) conducted completed single face-to-face appointment. Data collected 1 included: working days date referral added waiting list total (minutes) referral. compared sample 133 referrals two-stage 68 one-stage process. 2 average (minutes), duration open assessments, within same data at Time (before introducing (after 10 nine referrals, respectively. Results Statistical Process Control (SPC) charts show reduction mean 160 30 days. reduced 33 minutes 23 minutes. SPC that between there (i) clinician (m = 236.8 m 210), (ii) remained 39.4 6.4), (iii) involving multiple appointments (6 3 9), (iv) month (3 7 9). Conclusion These results promise towards increasing DCF across pathway, but further PDSAs (e.g., digitalising reporting, refining pathway) need be implemented achieve overall aim.