Background 

 The demand-capacity levels offering Pulmonary Rehabilitation to our local population has become increasingly challenging post Covid 19 pandemic. Remotely delivered assessments, which during the pandemic were introduced as an alternative model for assessing patients suitability to enter the PR program were utilised by our service to  improve capacity and meet the increased service?s demand.

Methods 

We used the QI ?Model for improvement? as a standardised QI methodology, and changes  tested in small cycles involving planning, doing, studying, acting (PDSA). We increased the number of telephone assessments, allowing a greater number of patients to get into the flow of the system and implemented a weekly system of evaluation assessing the following metrics: waiting times from referral to starting PR, reduction on the demand/capacity ratio, attendance rate and percentage of patients enrolment in PR service. Patient satisfaction is also recorded. 

Results  

Service capacity increased from 60 assessments/month to 128 (20tele and 12 face to face).  Waiting list reduction from 283 in October to 102 within a period of 90 days - average constant referral rate remains 70/month. Attendance rate recorded 20% above the conventional face to face assessments. Patient positive feedback recorded. The QI is ongoing and expected in two months time the capacity will meet demand levels at a sustainable ratio.

Concusion

Evalution stages of the King's QI to reduce waiting lists by increasing the number of remotely delivered assessments was shown to be successful. Validity and reliability of this model remains to be determined.