Improving efficiency of referral triage for ambulatory pain management service for improved patient access and flow

Mrs Swapna Gokhale1

1Eastern Health, Glen Waverley, Australia


Evidence suggests that delays in access to treatment for chronic pain are associated with deterioration in health-related quality of life and psychological well-being. The aim of this project was to improve the efficiency of referral triage for the EH APMS by addressing problems with access, scheduling, and management of patient flow through the service.

Service data was collected and analyzed to identify validated root causes and understand supply and demand. Interventions were targeted at reducing double handling by redesigning the referral process, standardising processes to create efficiency, and a brief referral triage tool was developed to direct patients to the most appropriate clinical pathway.

Outcome measures used were referral waiting times, on task referral processing times and levels of clinician confidence in various aspects of referral triage. At four months post implementation, project evaluation revealed 70% reduction in wait times to access the service (from 32.1 to 9.5 days), 42% reduction in on task referral processing times (from average 67 mins/referral to 39 mins/referral).

Significance to Allied Health:
This project has demonstrated that significant improvements in access to pain management services can be achieved with improving efficiency of referral processes and using the STAT principles of providing early face to face appointments and combining triage and early assessment to provide patient centred care.


Swapna is the Team leader and Senior Physiotherapist who looks after the Ambulatory Pain Service in Eastern Health

Swapna believes that being compassionate and having an open mind is crucial to delivering innovative client centred care. Swapna has recently completed the BCV Clinician in Redesign Internship and is currently evaluating her project addressing the triage issues affecting patient access and flow in her service.

Swapna has recently completed her Masters in Physiotherapy from La Trobe University. She has a keen interest in synergistic links between healthcare innovation and improvement methodology and research.