Doctors are very good at listening, learning and adapting. When research began showing that asthma is over-diagnosed in Canada, local community physicians listened and adapted. They started requesting the tests required to correctly diagnose the condition — spirometry and methacholine challenge testing, which is only available for children and youth at CHEO’s Pulmonary Function Lab (CPL). As a result, community requests for this testing increased and wait times to crept up, becoming as long as nine months.
Then it was CHEO’s turn to listen and adapt.
CHEO pediatric respirologist Dr. Tom Kovesi and the CPL staff changed the way they worked, allowing them to absorb this new, heavier workload and get wait times back down to three months.
"The first thing we did was design a new requisition form to guide community physicians to order the right tests," Dr. Kovesi says. “The next thing we did was to have me personally triage every request coming in."
The goal was to ensure that no unnecessary tests were done, which is better for patients and for the use of CHEO resources.
In addition to assisting community physicians, the CPL team also adjusted how appointments are booked. Taking advantage of Epic — CHEO’s new electronic health records system — Sue Simard, a CHEO patient services clerk, carefully reviewed what types of test requests the lab was receiving. Since some tests take just 15 minutes, some 30, and a full pulmonary function test takes one hour, efficient booking practice ensures best use of the lab’s time.
With this analysis, the CPL made careful, targeted adjustments to how appointments are scheduled, keeping the lab fully booked and avoiding downtime.
As a result of these two simple initiatives — Dr. Kovesi assisting community physicians and efficient lab scheduling — the average wait-time for testing in the CPL is now under three months. Short of the 60 days that the lab once enjoyed but still a remarkable reduction, down over 60 per cent from the peak wait-time.
"This is a fantastic innovation from our respiratory therapists, Carol Dimanche and Carlie Brown, our patient services clerk, Sue Simard, and Dr. Kovesi," says Ariyan Marvizi, a manager in Ambulatory Care. "I expect that other clinics at CHEO will see similar results as we learn more about how to harness the power of Epic.”
Epic is currently in use throughout Ambulatory Care at CHEO. This fall, the rest of the hospital will start using the integrated electronic health record system.
For more information on Epic
About CHEO – OCTC
The Children’s Hospital of Eastern Ontario – Ottawa Children’s Treatment Centre (CHEO – OCTC) is the leading provider of specialized pediatric health services in Canada's capital. The two previously separate organizations joined forces in 2016 to become one organization — stronger together for kids and families.
CHEO’s programs help more than 500,000 children and youth each year in Eastern Ontario, Western Quebec, Nunavut and parts of Northern Ontario. As a world-class research centre and teaching hospital, for over 40 years CHEO has changed young lives in our community, while our innovations change young lives around the world.
For more than 65 years, OCTC has been providing specialized care for children and youth with disabilities, including cerebral palsy, complex needs associated with congenital conditions, developmental delay, autism spectrum disorders and brain injury. OCTC's vision is to create opportunities today, while maximizing independence tomorrow.
Office: 613-737-7600 ext. 3536